MERCY HEALTH - URBANA HOSPITAL

"Individuals with an income level at 200% FPG or below receive free care."

documented · checked 2026-10-14 · [PDF] Healthcare Financial Assistance (HFA) Policy Number - Mercy Health

"Proof of income is required with exception of patients who qualify for presumptive eligibility detailed below. See the Application Process for HFA section below for details."

documented · checked 2026-10-14 · [PDF] Healthcare Financial Assistance (HFA) Policy Number - Mercy Health

"* [English](/-/media/mercy/patient-resources/financial-assistance/2024/english/mercy-health-2024-application_final_clean.pdf) * [Arabic](/-/media/mercy/patient-resources/financial-assistance/2024/arabic/mercy-health-application-arabic.pdf) * [Cambodian](/-/media/mercy/patient-resources/financial-assistance/application/cambodian.pdf) * [Cantonese](/-/media/mercy/patient-resources/financial-assistance/application/cantonese.pdf) * [Dari](/-/media/mercy/patient-resources/financial-assistance/2024/dari/mercy-health-application-dari.pdf) * [French](/-/media/mercy/patient-resources/financial-assistance/2024/french/mercy-health-application-french.pdf) * [Gujarati](/-/media/mercy/patient-resources/financial-assistance/2024/gujarati/mercy-health-application-gujarati.pdf) * [Haitian Creole](/-/media/mercy/patient-resources/financial-assistance/2024/haitian/mercy-health-application-haitian.pdf) * [Hindi](/-/media/mercy/patient-resources/financial-assistance/application/hindi.pdf) * [Korean](/-/media/mercy/patient-resources/financial-assistance/2024/korean/mercy-health-application-korean.pdf) * [Mandarin](/-/media/mercy/patient-resources/financial-assistance/application/mandarin.pdf) * [Nepali](/-/media/mercy/patient-resources/financial-assistance/2024/nepali/mercy-health-application-nepali.pdf) * [Pashto](/-/media/mercy/patient-resources/financial-assistance/2024/pashto/mercy-health-application-pashto.pdf) * [Portuguese](/-/media/mercy/patient-resources/financial-assistance/2024/portuguese/mercy-health-application-portuguese.pdf) * [Punjabi](/-/media/mercy/patient-resources/financial-assistance/application/punjabi.pdf) * [Russian](/-/media/mercy/patient-resources/financial-assistance/2024/russian/mercy-health-application-russian.pdf) * [Spanish](/-/media/mercy/patient-resources/financial-assistance/2024/spanish/mercy-health-application-spanish.pdf) * [Swahili](/-/media/mercy/patient-resources/financial-assistance/application/swahili.pdf) * [Uzbek](/-/media/mercy/patient-resources/financial-assistance/application/uzbek.pdf) * [Vietnamese](/-/media/mercy/patient-resources/financial-assistance/2024/vietnamese/mercy-health-application-vietnamese.pdf)"

documented · checked 2026-10-14 · Financial Assistance Policy | Patient Resources | Mercy Health

"Mercy Health – Urbana Hospital 904 Scioto St, Urbana, OH 43078 Dept: Financial Counseling"

documented · checked 2026-10-14 · [PDF] Healthcare Financial Assistance (HFA) Policy Number - Mercy Health