Your Bill

Download a HOPE checklist

 

If you are a Florida Resident:

Hope Application

P.A.T.H. Program Application

Pregnancy Medicaid Application 

 

If you are a Georgia Resident:

Hope Application

Financial Screening

 

If you have any questions about the HOPE Program or application process, please contact one of the HOPE counselors at 904-308-1956.

HOPE/Financial Assistance

Hope Program

 

Each year St. Vincent’s HealthCare matches more than 5,000 uninsured patients with coverage.

St. Vincent’s HealthCare is excited to announce the launch of the Hospital Outreach Patient Eligibility (HOPE) Program which aims at improving access to medical care for individuals who are experiencing financial hardship by enrolling those that qualify into financial assistance programs.  St. Vincent’s HealthCare Financial Counselors work diligently to make the process as seamless as possible and offer financial assistance services at both St. Vincent’s Medical Center Riverside and St. Vincent's Medical Center Southside, formerly St. Luke's Hospital. The HOPE Program provides services that meet the needs of patients who are unable to pay for their care.  These services include:

  • Medicaid, including Medicaid PSN and Medicaid HMOs
  • Florida KidCare, Healthy Kids
  • Charity Applications
  • Financial counseling and payment arrangements
  • Other State and Federally funded programs
  • Finding a Physician

Hope Associates

Patients are supervised by a Financial Counselor throughout the entire process to ensure accuracy and completeness.  In order to make the process as seamless as possible, applicants are encouraged to be prepared to answer questions regarding household members, employment/income information, and asset information.   Applicants are required to bring their medical bill(s), personal forms and documents, and identification with them in order to complete the application process.

 

HOPE Checklist

  • You must apply for and comply with the application process for any available local, state, or federally funded program for which you may qualify.  Failure to do so will result in a denial of your application.
  • You are responsible for all medical service charges until your application for financial assistance is approved.

Please have the following items with you when you apply:

  • Applicant’s Proof of ID (submit at least two)
    • i.e. birth certificate, passport, alien registration card, picture ID, driver’s license
    • Household income information for the last 4 weeks
      • i.e. check stubs, unemployment letter, signed letter of support if receiving no income
      • Applicant’s Proof of Assets
        • i.e. proof of checking or savings account, life insurance, vehicle registration

       Additional information and/or documentation may be required to complete your application.  All information is subject to verification.  Providing false information may result in a DENIAL of any type of financial assistance through SVHC.

      Approval is subject to the assurance that you will apply for and assign to this facility any benefits available from insurance, liability insurance (PIP/Bodily Injury), Medicare, Medicaid, or public assistance as a result of our service provided to you.  All other funding sources not limited those listed above and including settlement funds take precedence to financial assistance.

      FORMS TO COMPLETE

      Please complete these forms ahead of time and bring to your appointment in order to expedite the application process.

      Download a HOPE checklist

       

      If you are a Florida Resident:

      Hope Application

      P.A.T.H. Program Application

      Pregnancy Medicaid Application 

       

      If you are a Georgia Resident:

      Hope Application

       

      In accordance with our Mission and Values, St. Vincent’s HealthCare is committed to caring for all people regardless of their ability to pay, with special attention to those who are poor and vulnerable.  St. Vincent’s HealthCare offers financial counseling and assistance to help address any financial concerns patients or families may have regarding their care. Our financial aid policies reflect St. Vincent’s HealthCare’s dedication to working together with our patients in a compassionate and caring manner to identify options for resolving their financial obligations. Help is available by contacting 904-308-1956, emailing HOPE@jaxehealth.com or in person at any of our facilities.