Financial Assistance
HMH Financial Assistance
As part of a commitment to serve the community and provide quality medical care to all of our patients, Huntsville Memorial Hospital provides a Financial Assistance Program to patients who satisfy certain requirements. This includes patients who don’t have health insurance and can’t pay their bill as well as patients who have coverage with an insurance carrier but are unable to pay their portion of the bill after insurance pays.
Financial Counseling
If you need an appointment to meet with a Financial Counselor, please call and schedule in advance.
Phone: (936) 293-4464
Hours:
Monday-Thursday 8am to 5pm
Closed Fridays
Huntsville Memorial Hospital

How to Apply
You may apply for Financial Assistance as soon as possible after presenting for services or indicating an inability to pay for services at the Hospital or Clinic.
Your application for Financial Assistance will include screening by a third party eligibility vendor for the following benefits/programs:
- Existing Healthcare Insurance or Ability to Purchase Healthcare Insurance and/or Other Liability – At or below 8% of total annual income (<8%) and/or Other Liability
- Self-Pay Discounted Programs – Means tested Federal Poverty Level (FPL) at or above 401% ( >401%)
- Texas Medicaid and/or Medicare and/or SSI; Other Government Programs; Workers Compensation – Meets all Federally Mandated Criteria
- Walker County Indigent Care Program – Means tested Federal Poverty Level (FPL) at or below 50%. (0% to <50%)
If you are approved for Financial Assistance, you will be notified by mail, no later than 14 days after the date your fully completed application and all required documents are submitted. Financial Assistance is approved for a 6 month period from the first date of service. You are required to reapply for Financial Assistance at the end of the 6 month qualification period. Services covered include only medically necessary services as defined by the Centers for Medicare and Medicaid Services. Financial Assistance approvals extend only to services provided by Huntsville Memorial Hospital and Clinic (see HMH Billing Disclosure).
The hospital’s financial counselors are available to answer questions and provide information about the Financial Assistance Policy and to assist with the financial assistance application process. The hospital’s financial counselors may be reached at 936-293-4464. The Financial Counseling Office is open Monday thru Thursday from 8:00 am to 5:00 pm.
APPLICATION DEADLINE

Please apply for financial assistance within 30 days of receiving treatment to indicate an inability to pay for services at the hospital or clinic.
Additional Information
Click the plus sign (+) to open more about financial assistance available at HMH.
Physician Specialties whose Professional Fees are Excluded (English)
- Anesthesia
- Cardiology
- Emergency Medicine
- Family Practice
- General Surgery
- Hand Surgery with Upper Extremities
- Hematology/Oncology
- Hospitalist
- Infectious Disease
- Internal Medicine
- Internal Medicine w/Pediatrics
- Medical Oncology
- Nephrology
- Neurosurgery
- Nurse Practitioner
- OB/GYN
- Ophthalmology
- Oral/Maxillofacial
- Orthopedic Surgery
- Otolaryngology
- Pain Management
- Pathology
- Pediatrics
- Physical Medicine and Rehabilitative Medicine
- Podiatry
- Pulmonary Medicine
- Radiation Oncology
- Radiology
- Rehab Medicine
- Teleneurology
- Teleradiology
- Urology
- Vas/Inter Radiology
- Wound Care
Physician Specialties whose Professional Fees are Excluded (Spanish)
- Anestesia
- Cardiología
- Medicina de Emergencia
- Práctica Familiar
- Cirugía General
- Cirugía de la mano con extremos superiores
- Hematología/Oncología
- Hospitalista
- Enfermedad infecciosa
- Medicina Interna
- Medicina Interna con Pediatría
- Oncología Médica
- Nefrología
- Neurocirugía
- Enfermera Practicante
- OB/GYN
- Oftalmología
- Oral/Maxilofacial
- Cirugía Ortopédica
- Otorrinolaringología Manejo del dolor
- Patología
- Pediatría Medicina
- Física y Medicina de Rehabilitación
- Podología Medicina
- Pulmonar
- Oncología Radioterápica
- Radiología Medicina de rehabilitación
- Teleneurología
- Telerradiología
- Urología
- Vas/Inter Radiología
- Cuidado de heridas
Providers Excluded from the Financial Assistance Program
Financial Counseling
The hospital’s financial counselors are available to answer questions and provide information about the Financial Assistance Policy and to assist with the financial assistance application process. The hospital’s financial counselors may be reached at (936) 293-4464. The Financial Counseling Office is open Monday through Thursday from 8:00 am to 5:00 pm.
Financial Assistance Policies
For a copy of the hospital’s Financial Assistance Policies see below:
- Financial Assistance Policy English
- Financial Assistance Policy Espanol
- Collections of Accounts Policy English
- Collections of Accounts Policy Espanol
- Discount Payment Plan FAP English
- Discount Payment Plan FAP Espanol
- Financial Counseling FAP Engish
- Financial Counseling FAP Espanol
- Widely Publicizing FAP English
- Widely Publicizing FAP Espanol
- Financial Assistance Application FAP English
- Financial Assistance Application FAP Espanol
Financial Assistance Documents
Financial Assistance Process, Application, Plain Language Summary and Other Document links:
- Financial Assistance – Charity Care Procedure 9020.109B English
- Financial Assistance – Charity Care Procedure 9020.109B Espanol
- Plain Language Summary English
- Plain Language Summary Espanol
- Billing Disclosure English
- Billing Disclosure Espanol
- Financial Assistance Eligibility Discount Guidelines; CY Federal Poverty English and Espanol
- Application Requirements English and Espanol
- Texas State Form 100 Application English and Espanol
- Supplemental Screening Form English
- Supplemental Screening Form Spanish
- Financial Assistance Determination Calculator and Approval English and Espanol
- Application for Appeal English
- Application for Appeal Spanish