HMH Financial Assistance

Speak with Us about Affordable Healthcare in Walker County

If you are in need of services at Huntsville Memorial Hospital and you are without health care coverage or have financial challenges, please print and complete a copy of the Texas Form 100.pdf and return the application to the Huntsville Memorial Hospital Financial Department within 30 days of your visit. Instructions for the application are below, and you may contact the Huntsville Memorial Hospital Financial Department at (936) 293-4464 or wcindigent@hmh.cc for additional information.

Financial Counseling hours: Monday -Thursday 8 a.m. to 5 p.m.; Closed Fridays

Financial Assistance Policy and Related Documents below:

• HMH Financial Assistance Policy
• HMH Financial Assistance Plain Language Summary
• Walker County Application Facts
• Charity Determination Calculator
• Billing Disclosure SB1731 and 501(r) Compliance English
• Billing Disclosure SB1731 and 501(r) Compliance Spanish
• Financial Assistance Policy Poverty Guidelines 2018
• Financial Assistance Policy Application Requirements
• Financial Assistance Policy Application for Appeal

Financial Assistance Application

For application click here

Additional information may be required to determine your eligibility, depending upon the program for which you are applying.

Eligibility Determination

Classification as Financially Indigent: To be eligible for charity care as a financially indigent patient, a person's gross annual income [1] shall be at or below 200 percent of the federal poverty guidelines and have no alternative resources available. The hospital may consider other financial assets and liabilities of the person when determining eligibility.

Classification as Medically Indigent: A medically indigent patient is a person whose medical or hospital bills after payment by third-party payers exceed a specific percentage of the person's annual gross income as set forth in this policy and who is unable to pay the remaining bill.