CHI ST LUKE'S HEALTH BRAZOSPORT

"Up to 200% of the FPL – Any patient whose Family Income is at or below 200% of the FPL, including, without limitation, any Uninsured or Underinsured patient, is eligible to receive Financial Assistance up to a 100% discount from his or her account balance for eligible services provided to the patient after payment, if any, by any thirdparty(ies)."

documented · checked 2026-10-10 · English

"Financial Assistance is offered to insured patients to the extent allowed under the patient’s insurance carrier contract."

documented · checked 2026-10-10 · English

"Medicaid patients who receive non-covered medically necessary services will be considered for Presumptive Financial Assistance."

documented · checked 2026-10-10 · English

"Mail or fax completed application with all documentation to: CHI St. Luke's Health - Brazosport, Attn: Business Office, 194 Abner Jackson Drive. Lake Jackson, TX 77556 Fax: 979-285-1730. Be sure to keep a copy for yourself. To submit your completed application in person: CHI St. Luke's Health - Brazosport Hospital, 100 Medical Drive, Lake Jackson, TX 77566"

documented · checked 2026-10-10 · Brazosport Hospital Financial Assistance Application Form ...

"We will notify you of the final determination of eligibility and appeal rights, if applicable, within 30 calendar days of receiving a complete financial assistance application, including documentation of income."

documented · checked 2026-10-10 · Brazosport Hospital Financial Assistance Application Form ...