# Essentia Health Moose Lake

Hospital in Moose Lake, MN. Verified from the hospital's own policy.

Essentia Health Moose Lake likely gives free care to households with a yearly income up to $31,920 for 1 person, $43,280 for 2, $54,640 for 3, $66,000 for 4, $77,360 for 5 or $88,720 for 6. It likely gives a discount to households with a yearly income up to $47,880 for 1 person, $64,920 for 2, $81,960 for 3, $99,000 for 4, $116,040 for 5 or $133,080 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 | $31,920 | $47,880 |
| 2 | $43,280 | $64,920 |
| 3 | $54,640 | $81,960 |
| 4 | $66,000 | $99,000 |
| 5 | $77,360 | $116,040 |
| 6 | $88,720 | $133,080 |

Dollar amounts use the 2026 federal poverty guidelines.

## Discount steps

- 0% to 200% of poverty level, patient pays nothing (100% discount)
- 201% to 300% of poverty level, patient pays 50% of charges (50% discount)

## How to apply

- Call 800-985-4675 and ask for financial assistance.
- [Application form](https://www.essentiahealth.org/-/media/Project/Essentia/Essentia/pages/documents/billing-finance/financial-assistance-application.pdf)
- [Financial Assistance Program (Policy #002578)](https://www.essentiahealth.org/-/media/Project/Essentia/Essentia/pages/documents/billing-finance/Financial-Assistance-Program-Policy.pdf)
- [Plain language summary](https://www.essentiahealth.org/-/media/Project/Essentia/Essentia/pages/documents/financial-assistance-brochure.pdf)
- We do not have the deadline yet. Apply as soon as you get a bill, and ask the billing office to pause collections while you apply.
- Bring federal tax return, last 2 months of pay stubs or other income proof, 2 most recent months of bank and other account statements, proof of residency (mortgage statement, utility bill or lease), Medicaid approval or denial letter if uninsured, letter explaining how you support yourself if you have no income.
- Residency. Must live in an Essentia Health service area for full coverage; people from outside it get help only for emergency care
- Savings and property. The policy counts savings or property, not only income.
- Very large bills. Bills over $5,000 for people above the income limit; patient pays no more than 20% of yearly income; once in a lifetime
- Languages. English, Spanish

## 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 medically necessary hospital and clinic care at Essentia Health, including bills from Essentia doctors. Approval lasts 12 months.

Not covered. Retail pharmacy, eyeglasses, hearing aids, cosmetic care, assisted living, skilled nursing and some other services are not covered. Doctors and groups that are not part of Essentia Health bill separately. Insured patients who go out of network get help only for emergency care.

## Notes

These income levels took effect July 1, 2026. Approval covers eligible bills for 12 months, and you need to reapply each year. Insured patients must use Essentia as an in-network provider for ongoing help. If you have no insurance, you will be asked to apply for Medicaid first. Return the application and papers within 30 days of when it was sent to you. A decision can take up to 45 business days, and collections are paused while your complete application is reviewed. Appeals must be in writing within 3 months. Uninsured patients get a discount at any income. At Minnesota hospitals, uninsured patients with household income under $125,000 are not charged more than the lowest private insurer rate. Payment plans are available. You can apply by mail, by email to FinancialAssistanceAppinfo@EssentiaHealth.org, or in MyChart.

## Sources

- Free care level https://www.essentiahealth.org/-/media/Project/Essentia/Essentia/pages/documents/billing-finance/Financial-Assistance-Program-Policy.pdf
  > Fully discounted care is provided when gross income is at or below 200% of the FPG.
- Discount level https://www.essentiahealth.org/-/media/Project/Essentia/Essentia/pages/documents/billing-finance/Financial-Assistance-Program-Policy.pdf
  > Partially discounted care (50% adjustment) is provided when gross income is between 201% and 300% of the FPG.
- Insured patients https://www.essentiahealth.org/-/media/Project/Essentia/Essentia/pages/documents/billing-finance/Financial-Assistance-Program-Policy.pdf
  > financial assistance to eligible patients who are uninsured or underinsured
- Asset test https://www.essentiahealth.org/-/media/Project/Essentia/Essentia/pages/documents/billing-finance/Financial-Assistance-Program-Policy.pdf
  > Whose Liquid Assets do not exceed Seventy-Five Thousand Dollars ($75,000) for household of one (1)
- Residency https://www.essentiahealth.org/-/media/Project/Essentia/Essentia/pages/documents/billing-finance/Financial-Assistance-Program-Policy.pdf
  > Patients who live outside a designated Essentia Health service area will not be eligible for full program coverage
- Very large bills https://www.essentiahealth.org/-/media/Project/Essentia/Essentia/pages/documents/billing-finance/Financial-Assistance-Program-Policy.pdf
  > Patient, or their Guarantor will pay no more than 20% of annual income on all eligible charges.
- Catastrophic threshold https://www.essentiahealth.org/-/media/Project/Essentia/Essentia/pages/documents/billing-finance/Financial-Assistance-Program-Policy.pdf
  > does not qualify but has a balance greater than Five Thousand Dollars ($5000)
- Documents https://www.essentiahealth.org/-/media/Project/Essentia/Essentia/pages/documents/billing-finance/financial-assistance-application.pdf
  > Documentation is required for all wage earners contributing to your household.
- Financial counseling phone https://www.essentiahealth.org/-/media/Project/Essentia/Essentia/pages/documents/financial-assistance-brochure.pdf
  > For questions regarding our Financial Assistance Program, you can call us at 800-985-4675
- Covered facility https://www.essentiahealth.org/-/media/Project/Essentia/Essentia/pages/documents/billing-finance/Financial-Assistance-Policy-Location-Listing-2024-updated-101124.pdf
  > Essentia Health Moose Lake
- Mn uninsured limit https://www.essentiahealth.org/-/media/Project/Essentia/Essentia/pages/documents/billing-finance/Financial-Assistance-Program-Policy.pdf
  > not to charge a patient whose annual household income is less than $125,000 for any uninsured service

Last checked 2026-11-11.

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