Metro Health Financial Assistance Eligibility Application
Metro Health offers Financial Assistance to cover current hospital bills.
To determine eligibility for Financial Assistance, you must attach proof of Income, Assets, and Expenses. Copies of this information must be returned with your application within 15 days.
1.If you are under 21, over 65, disabled, or a child caretaker, a Medicaid application is necessary. If you do not qualify for Medicaid, a copy of the Medicaid denial should be included with the application.
2.Please complete the application. All sections need to be completed.
3.Attach proof of all gross household income listed on the Financial Assistance Application for the past 12 months or last 90 days.
4.Attach proof of assets.
5.Failure to provide requested copies may result in a Financial Assistance denial.
6.The copies that you send will not be returned.
If you have any questions, please contact our Customer Service Representative at (616) 252-7110 or 1-800-968-0051 extension 7110.
Financial Assistance Application