Financial Assistance

Geisinger is committed to providing healthcare to those in need, regardless of their ability to pay, so we offer a generous Financial Assistance Program.
To find out if you are eligible for Geisinger's Financial Assistance Program, print the financial statement application and complete all fields on the form. Use "N/A" if the information does not apply. Applications with missing or incomplete information will be returned to you for the information to be provided, resulting in a delay in processing or possible denial. Upon completion of the form, please review for accuracy and mail with all applicable information outlined below to:

Geisinger Uncompensated Care Services 49-38
100 N. Academy Avenue
Danville, PA 17822-0002

All of the following documents are required, in addition to the completed financial statement, for your application to be processed:

If you have questions or need help completing the form, call our Patient Service Call Center at 1-800-640-4206.

The types of proof of income to be returned with the complete financial statement vary. Include all items below that apply to you:

Employed – Copies of the four most recent pay stubs for the income(s) of all members of the household. If this is not available, a letter from your employer on their letterhead outlining the same information is acceptable.

Unemployment Compensation - Copy of the eligibility determination letter must be submitted.

Unemployed - If no income exists, a notarized letter stating there is no income being received from any source is required.

Social Security Recipient – A copy of the current year’s benefit determination letter is acceptable.

Disability Recipient – A copy of the Benefit Determination letter is acceptable.

Pension Recipient - Copy of pension check or a letter from the pension’s source stating the dollar amount of the monthly benefit.
In the event a Medical Assistance application has been submitted recently and rejected, a copy of the rejection letter (in addition to any other previously listed information that may apply) is requested. 

Note: Guidelines for Geisinger-Bloomsburg Hospital differ from those of the rest of Geisinger Health System. Geisinger-Bloomsburg Hospital patients should follow the guidelines here (pdf).

If you have any questions or need help completing the statement, contact the Patient Service Call Center at 1-800-468-7201

Financial assistance policy

You are responsible for applying for financial assistance. Geisinger Health System will make application materials easily available. To request an application, call 1-800-468-7201.