# Ascension St. John Medical Center

Hospital in Tulsa, OK. Verified from the hospital's own policy.

Ascension St. John Medical Center likely gives free care to households with a yearly income up to $39,900 for 1 person, $54,100 for 2, $68,300 for 3, $82,500 for 4, $96,700 for 5 or $110,900 for 6. It likely gives a discount to households with a yearly income up to $63,840 for 1 person, $86,560 for 2, $109,280 for 3, $132,000 for 4, $154,720 for 5 or $177,440 for 6.

The hospital makes the final decision.

| Household size | Free care if yearly income is up to | Discount if yearly income is up to |
|---|---|---|
| 1 | $39,900 | $63,840 |
| 2 | $54,100 | $86,560 |
| 3 | $68,300 | $109,280 |
| 4 | $82,500 | $132,000 |
| 5 | $96,700 | $154,720 |
| 6 | $110,900 | $177,440 |

Dollar amounts use the 2026 federal poverty guidelines.

## Discount steps

- 0% to 250% of poverty level, patient pays nothing (100% discount)
- 251% to 300% of poverty level, patient pays 20% of the bill (80% discount)
- 301% to 399% of poverty level, patient pays 25% of the bill (75% discount)

## How to apply

- Call 800-298-8329 and ask for financial assistance.
- [Application form](https://healthcare.ascension.org/-/media/healthcare/financial-assistance/oklahoma/fap-application/runningfile_oktul_english_financial-assistance-application.pdf)
- [Financial Assistance Policy (10/01/25)](https://healthcare.ascension.org/-/media/healthcare/financial-assistance/oklahoma/fap/runningfile_oktul_english_financial-assistance-policy.pdf)
- [Plain language summary](https://healthcare.ascension.org/-/media/healthcare/financial-assistance/oklahoma/plain-language-summary/runningfile_oktul_english_financial-assistance-policy-summary.pdf)
- The policy gives 240 days to apply. Ask the billing office which date the count starts from.
- Bring proof of income (for example 3 most recent pay stubs, latest tax return, Social Security or pension award letter, or unemployment benefits), proof of assets (for example bank statements from the last 3 months, stocks, bonds, trust funds), bills for outstanding medical and pharmacy costs, if asking for help based on medical debt, Medicaid approval or denial letter, if you have one.
- Residency. Lives in the hospital's service area (Tulsa County for this hospital). Emergency visits and admissions from the emergency room are exempt for that date of service
- Savings and property. The policy counts savings or property, not only income.
- Very large bills. Income above 400% of poverty level can still get the same discount as 400% if total medical debt (to Ascension and other providers) equals or exceeds household income

## If you have insurance

Insured patients can also apply for help with deductibles and copays.
Keep your insurance. Financial assistance covers bills from this one place only.

## What is covered

Covered. Emergency and other medically necessary care, including care from doctors the hospital employs and behavioral health. Scheduled future care must be approved by the hospital's chief medical officer to count as medically necessary.

Not covered. Care that is not emergency or medically necessary is not covered. Some doctors who work in the hospital are not covered, so check the list of covered providers. If your insurance treats the hospital as out of network, help may be reduced or denied.

## State program in Oklahoma

### Discount program for self-pay patients (63 O.S. 1-723.2)

Every hospital in Oklahoma must have a discount program for patients with no hospital insurance whose household income is up to 300% of the federal poverty level. With the discount, the bill can be no more than what Medicare would pay, or the hospital's cost for the care, whichever is higher. This is a price cap. It does not make the bill free. It does not cover patients who have or can get insurance with hospital coverage, and it does not cover care the treating doctor says was not medically necessary. You have to show the hospital you meet the rules. If the hospital sues you over the bill, you can raise this law as a defense.

Income levels in the program are discount up to 300% of poverty level.

Applies to each hospital in Oklahoma, for self-pay patients who are not eligible for or enrolled in insurance with hospital coverage.

How to apply. Ask the hospital's billing or financial assistance office for its self-pay discount program. Bring proof of household income and be ready to show you have no insurance with hospital coverage.

> Each hospital in this state shall establish a discount program for hospital charges for qualified self-pay patients

Source https://www.oscn.net/applications/oscn/DeliverDocument.asp?CiteID=446820, checked 2026-11-11

## Notes

Free care up to 250% of the poverty level, but approved patients still pay a small fee: $100 per date of service for emergency or inpatient care, and $25 per outpatient visit up to $250. Discounts of 75% to 80% apply from 251% to about 400%. Patients who live outside the service area cannot apply, except for emergencies or a referral for a service not available near home. Apply within 240 days of the first bill after discharge to get the full benefit. You can still apply later, but then help only covers what you have not paid yet. Uninsured patients must work with a financial counselor to apply for Medicaid or other programs first. Ascension may also approve help without an application by checking public records. A denial can be appealed within 14 days. Patients who do not qualify still get an uninsured discount and may get a prompt pay discount. Assets above 250% of your poverty level amount can make you ineligible.

## Sources

- Free care level https://healthcare.ascension.org/-/media/healthcare/financial-assistance/oklahoma/fap/runningfile_oktul_english_financial-assistance-policy.pdf
  > Patients with income less than or equal to 250% of the Federal Poverty Level income (“FPL”), will be eligible for 100% charity care
- Discount level https://healthcare.ascension.org/-/media/healthcare/financial-assistance/oklahoma/fap/runningfile_oktul_english_financial-assistance-policy.pdf
  > Patients with incomes above 250% of the FPL but not exceeding 400% of the FPL, will receive a sliding scale discount
- Insured patients https://healthcare.ascension.org/-/media/healthcare/financial-assistance/oklahoma/fap/runningfile_oktul_english_financial-assistance-policy.pdf
  > on that portion of the charges for services for which the Patient is responsible following payment by an insurer, if any
- Asset test https://healthcare.ascension.org/-/media/healthcare/financial-assistance/oklahoma/fap/runningfile_oktul_english_financial-assistance-policy.pdf
  > if such Patient is deemed to have sufficient assets to pay pursuant to an “Asset Test.”
- Residency https://healthcare.ascension.org/-/media/healthcare/financial-assistance/oklahoma/fap/runningfile_oktul_english_financial-assistance-policy.pdf
  > Financial assistance described in this section is limited to Patients that live in the Community
- Very large bills https://healthcare.ascension.org/-/media/healthcare/financial-assistance/oklahoma/fap/runningfile_oktul_english_financial-assistance-policy.pdf
  > A Patient will be eligible for financial assistance pursuant to the Means Test if the Patient has excessive total medical debt
- Very large bills https://healthcare.ascension.org/-/media/healthcare/financial-assistance/oklahoma/fap/runningfile_oktul_english_financial-assistance-policy.pdf
  > that is equal to or greater than such Patient’s household’s gross income
- Deadline https://healthcare.ascension.org/-/media/healthcare/financial-assistance/oklahoma/fap/runningfile_oktul_english_financial-assistance-policy.pdf
  > submits a financial assistance application (an “Application”) on or prior to the 240th day after the Patient’s first discharge bill
- Discount steps https://healthcare.ascension.org/-/media/healthcare/financial-assistance/oklahoma/fap/runningfile_oktul_english_financial-assistance-policy.pdf
  > 251% - 300% FPL Base = 80% write off 301% - 399% FPL Base = 75% write off
- Residency https://healthcare.ascension.org/-/media/healthcare/financial-assistance/oklahoma/fap/runningfile_oktul_english_financial-assistance-policy.pdf
  > If a patient lives outside of the defined catchment area where they are seeking services, they are not eligible to apply for financial assistance
- Covered facility https://healthcare.ascension.org/-/media/healthcare/financial-assistance/oklahoma/fap/runningfile_oktul_english_financial-assistance-policy.pdf
  > Ascension St. John Medical Center
- Documents https://healthcare.ascension.org/-/media/healthcare/financial-assistance/oklahoma/fap-application/runningfile_oktul_english_financial-assistance-application.pdf
  > Copies of 3 most recent paystubs from employer

Last checked 2026-11-11.

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