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Diverse Community Healthcare

Financial assistance

Apply for financial assistance

If you are having trouble paying your bill, you can apply for financial assistance. Each application is reviewed individually, and help is not guaranteed. It takes about five minutes, and proof of income is optional.

  1. About you, current step
  2. Household and income
  3. Review and sign

Step 1 of 3

About you

As it appears on your statement.

Adults 18 and older.

For questions about your application.

We send our decision here.

Where your statements go.

Top right of your statement. Helps us find you faster.

Preferred language
Not for emergencies. If you think you have a medical emergency, call 911. Please don't include detailed medical information in this form.

What happens next

  1. We review it

    Within five business days.

  2. You hear from us

    We email you our decision. We call if we need anything else.

  3. If you are approved

    We apply it to balances from visits with us for 12 months. Then you can apply again.

Medicaid, CHIP or a Medicare Savings Program

If you have Medicaid, CHIP or a Medicare Savings Program, tell us. Covered services usually should not be billed to you, and we will review your account.