- The patient has no assets that could be appropriately used to pay medical debt
- The patient is ineligible for aid under county, state and federal programs
- The patient lives in Dane County or the surrounding counties
- The care is medically necessary
- UW Health is the appropriate provider for the level of care required by the patient
- The patient's family income level is at or below 500 percent of the federal poverty guidelines
- The patient's medical debt is more than 50 percent of the annual household income, irrespective of income level
For more information about the Community Care program, contact UW Hospital and Clinics at (608) 262-2221 or toll-free at (866) 841-8535 or UW Medical Foundation at (608) 829-5254 or toll-free at (877) 565-8855.
Please complete the form and return with your latest tax return, two recent pay stubs and/or two recent bank statements to:
- UW Hospital and Clinics Patient Accounts, 301 S. Westfield Rd, Ste 120, Madison, WI 53717, or
- UW Medical Foundation Patient Accounts, 7974 UW Health Ct., Middleton, WI 53562
UW Health has partnered with United Way of Dane County to fund a program called HealthConnect, which will link people with lower incomes who live in Dane County to health insurance by providing financial assistance with their premium when they purchase insurance through the Marketplace. This program is supported through a $2 million dollar contribution from UW Health.