BAYLOR UNIVERSITY MEDICAL CENTER

""Financially Indigent" means a patient whose Yearly Household Income is less than or equal to 200 percent of the Federal Poverty Guidelines ("FPG"). These Financially Indigent patients are eligible for a 100% discount on outstanding patient account balances based on Schedule A (see below) of the Financial Assistance Eligibility Discount Guidelines (Attachment B) of Baylor Scott & White's Financial Assistance policy."

documented · checked 2026-10-11 · Financial Assistance Program | Baylor Scott & White Health

"This includes patients who don't have health insurance and can't pay their bill as well as patients who have coverage with an insurance carrier but are unable to pay their portion of the bill after insurance pays."

documented · checked 2026-10-11 · Financial Assistance Program | Baylor Scott & White Health

"* Proof of participation in governmental assistance programs such as food stamps, County Indigent Health Program (CDIC), Aids to Families with Dependent Children (AFDC), Medicaid, Women, Infants, and Children (WIC), or Temporary Assistance for Needy Families (TANF), TexCare Partnership"

documented · checked 2026-10-11 · Financial Assistance Program | Baylor Scott & White Health

"* Household Size1 * Yearly Household Income2, which must be verified by one or more of the following financial documentation (listed in order of preference): * Pay check remittance * W-2 * Wage and Tax Statement * Individual tax return * Telephone verification by employer of Patient’s Reported Income * Social Security payment remittance * Worker’s compensation payment remittance * Unemployment insurance payment notice * Unemployment compensation determination letters * Proof of participation in governmental assistance programs such as food stamps, County Indigent Health Program (CDIC), Aids to Families with Dependent Children (AFDC), Medicaid, Women, Infants, and Children (WIC), or Temporary Assistance for Needy Families (TANF), TexCare Partnership * Bank statements * Response from a credit inquiry * Or other appropriate indicators of patient's reported income"

documented · checked 2026-10-11 · Financial Assistance Program | Baylor Scott & White Health

"If you believe you qualify for financial assistance and have not spoken with a financial counselor or received a discount, then you should complete Baylor Scott & White's Financial Assistance Application through any of the following options:"

documented · checked 2026-10-11 · Financial Assistance Program | Baylor Scott & White Health

"Patients may apply for financial assistance from the date a patient is scheduled for service through the 365th day after the first billing statement is provided."

documented · checked 2026-10-11 · Financial Assistance Program | Baylor Scott & White Health