Financial Assistance Program
UW Health's Financial Assistance Program helps people who are unable to pay for the medical services they receive. For eligible patients, UW Health may reduce bills in part or in full.
How does it work?
Financial counseling staff use the following guidelines to determine patient qualification:
- If the household income is at or below 300% of the Federal Poverty Guidelines, you may have no financial responsibility for the care given by UW Health
- If you fall between 300% and 500%, you may get a discount. Persons eligible for financial assistance will not be charged more for emergency or other medically necessary care than amounts generally billed to individuals who have insurance.
- UW Health is the appropriate provider
- The care is medically necessary
- You are not eligible for any county, state or federal health insurance program
- You don't have the option or the ability to purchase health insurance
How do I apply for financial assistance?
Please complete the Financial Statement form (pdf) and return with your latest tax return, two recent pay stubs and two recent bank statements to:
UW Health Patient Business Services
7974 UW Health Court
Middleton, WI 53562
Financial Assistance Policy Forms
- Financial Assistance Policy (pdf)
Póliza de Asistencia Financiera (pdf)
- Financial Assistance Policy: Appendix A - Amount Generally Billed (pdf)
Apéndice A Cantidad Facturada Generalmente (pdf)
- Financial Assistance Policy: Appendix B - Categories of Service (pdf)
Apéndice B Categorias de Servicio de Asistencia Financiera (pdf)
- Financial Assistance Policy: Appendix C - Contact Information (pdf)
Apéndice C Informacion de Contacto (pdf)
- Financial Assistance Policy: Appendix D - Adjustment Levels (pdf)
Apéndice D Niveles de ajuste de Asistencia Financiera (pdf)
- Financial Assistance Policy: Appendix E - Eligible Providers/Facilities Other Than UW Health (pdf)
Apéndice e Otros Proveedores e Instalaciones Elegibles Ademas de UW Health (pdf)
- Financial Statement (pdf)
Declaración Financiera (pdf)
- Patient Billing and Collections Policy (pdf)
Póliza de Facturación y Cobro del Paciente (pdf)
UW Health partners 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 contribution from UW Health.