Community Care Program

Please read the following before proceeding to the online application.

Fort HealthCare is proud of its mission to improve the health and well-being of our community.  Fort HealthCare understands that concerns over payment of a medical bill should never get in the way of a patient receiving excellent healthcare. While Fort HealthCare expects our patients and family members to contribute to the cost of their care, we take into account each individual's ability to pay. Our goal is to work with each individual and offer financial aid options such as the Community Care Program.

The Community Care Program assists individuals in meeting their financial responsibilities. Community Care is not only based on income but also takes into consideration the size of the family, the amount of the balance and ability to pay.

Fort HealthCare uses the Federal Poverty Guidelines, which is published yearly, to assist our decision regarding your eligibility for this discount program. Even individuals and families whose income level is 300 percent over the poverty guidelines are still eligible for Community Care. To assist in the process we ask you to fill out the Financial Questionnaire and supply the required documentation. Upon review of the application, Community Care eligibility and payment expectations will be determined.*

A written notice of our Community Care determination will be sent to you within ten to fourteen days beginning with receipt of a completed application.

If you have questions concerning Community Care or how to apply for this program, please call the Fort HealthCare Business Services office at (866) 924-5493 and we will gladly assist you. Otherwise, click the application link below and you will be ready to start.

Sincerely,
Fort HealthCare Business Services office

*Fort HealthCare reserves the right to withdraw the approved Community Care if it is determined that an individual provided fraudulent information on their application. Community Care approvals will not automatically extend to future services provided by Fort HealthCare.

Fort HealthCare
Services For Health

View Our Interactive Map

Creating Well Communities

Contact Us

Call (920) 568-5000

La linea de mensajes

(920) 568-5001

Subscribe

  • RSS News Feed
  • Health365 eNewsletter
     
     
     

© Fort HealthCare 2014. Privacy Policy: English | Spanish | Vendor Program | Social Media Guidelines
611 Sherman Avenue East, Fort Atkinson, WI 53538 | (920) 568-5000