Financial Assistance

Contact us at(888) 311-1283if you have concerns about paying for your services. We will assist you with a review of your financial situation to determine if you are eligible for financial assistance.

You can request financial assistance before, during, or up to 240 days after the first billing statement for those services or 12 months after you have paid for them.

If you qualify, we will give you free or discounted care for up to twelve months. You can apply again if you need more care.

Download thefinancial assistance policy.

Apply for Financial Assistance

Here are instructions and a form to fill out for financial assistance:

• Instructions And Form For Applying For Financial Assistance
• Instrucciones para completar la solicitud (Spanish)
• Инструкции по заполнению заявки (Russian)
• 申请表填写说明 (Chinese)
• Hướng dẫn điền đơn đăng ký (Vietnamese)
• يونملكقفعطصدختةبائ†ت (Arabic)

You may also start an application online by goinghere.

If you need help or have questions, contact us at(503) 494-8551. We are open Monday through Friday 9 a.m. until 4:30 p.m.

The Oregon Health Authority also has information online abouthealth insurance for low-incomeOregonians. If you need assistance with applying to Medicaid our Medicaid Specialist team can help. Contact us at(503) 251-6807.

Financial Assistance Policy - Plain Language Summary

• Financial Assistance Policy – Plain Language Summary
• POLÍTICA DE ASISTENCIA FINANCIERA: RESUMEN EN LENGUAJE SENCILLO (Spanish)
• ПОЛИТИКА ФИНАНСОВОЙ ПОМОЩИ. Краткое и понятное описание (Russian)
• 经济援助政策 — 简明摘要 (Chinese)
• CHÍNH SÁCH HỖ TRỢ TÀI CHÍNH – TÓM TẮT RÕ RÀNG NGẮN GỌN (Vietnamese)
• سیاسة†المساعدة†المالیة†– ملخص†بلغة†واضحة (Arabic)

Appealing Financial Assistance

If you are denied financial assistance after providing an application and verification documents, and you believe the determination does not accurately reflect your current financial situation, you may appeal. To request an appeal, please complete the form below and include all appropriate details.

• Financial Assistance Appeal Request Form
• Formulario de solicitud de ayuda económica (Spanish)
• Форма запроса на апелляцию относительно получения финансовой помощи (Russian)
• 经济援助上诉申请表 (Chinese)
• Mẫu đơn yêu cầu kháng cáo về hỗ trợ tài chính (Vietnamese)
• ﻧﻤﻮذج طﻠﺐ اﻟﻄﻌﻦ ﻋﻠﻰ ﻗﺮار ﺑﺸﺄن اﻟﻤﺴﺎﻋﺪة اﻟﻤﺎﻟﯿﺔ (Arabic)
• 재정 지원 이의 신청 양식 (Korean)