# Longmont United Hospital

Hospital in Longmont, CO. Verified from the hospital's own policy.

Longmont United Hospital 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 uninsured: nothing; insured: $650 copay per inpatient, observation or same-day surgery visit, $50 per outpatient visit, 15% of CommonSpirit doctor fees
- 251% to 299% of poverty level, patient pays 10% of hospital charges, 25% of CommonSpirit doctor fees
- 300% to 399% of poverty level, patient pays 20% of hospital charges, 35% of CommonSpirit doctor fees

## How to apply

- Call 303-651-5102 and ask for financial assistance.
- [Application form](https://csdam.widen.net/s/z2tgdtk2jp/financial-assistance-required-documentation)
- [Financial Assistance Program, Patients (CommonSpirit Health Mountain Region)](https://csdam.widen.net/s/7k58d7g55q/financial-assistance-policy)
- [Plain language summary](https://csdam.widen.net/s/gdtvggffsh/chadm-011-process-of-applying-for-financial-assistance)
- The policy gives 240 days to apply. Ask the billing office which date the count starts from.
- Bring photo ID, proof of address (2 items, such as a utility bill, lease or rent receipt), proof of income for the last 90 days for everyone in the household (tax return, W-2, pay stubs, benefit letters), bank statements for the last 3 months, statements for savings, investments, trust funds and similar assets, copies of all insurance cards, or a letter saying you have no insurance, any crowdfunding or gift fund set up to pay medical bills, a notarized letter explaining how you get by, if you have no income.
- Residency. Must live in the hospital's market service area, unless the visit was urgent or an emergency
- Savings and property. The policy counts savings or property, not only income.
- Very large bills. What the patient owes under the policy will not be more than 25% of yearly income
- 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 other medically necessary care at the hospital, and at the CommonSpirit doctors and practices listed in the policy.

Not covered. Care that is not medically necessary is not covered. Some doctors who work at the hospital bill on their own and are not covered (see Addendum C of the policy). Scheduled care for people who live outside the service area needs approval first. People who live outside the United States need approval first.

## State program in Colorado

### Colorado Hospital Discounted Care (C.R.S. 25.5-3-501 et seq., from HB 21-1198)

Colorado law says general and critical access hospitals, their outpatient sites, and freestanding emergency rooms must limit hospital bills for Colorado residents whose household income is at or below 250% of the federal poverty level. You are asked to state that you live in Colorado. The bill can be no more than state set rates, which are about what Medicare or Medicaid would pay, whichever is higher. Payments are split into monthly amounts. A hospital bill can take no more than 4% of your monthly household income, each doctor's bill no more than 2%, and one combined bill no more than 6%. After 36 monthly payments, the rest of the bill is wiped out. Uninsured patients are screened automatically unless they say no. Patients with insurance can ask to be screened. You may qualify even if you are an immigrant. The law does not set an income level for a fully free bill. Each hospital sets its own free care rules, and many go higher than this.

Income levels in the program are discount up to 250% of poverty level.

Applies to Colorado hospitals licensed as general hospitals (including critical access hospitals), Denver Health and University of Colorado Hospital, freestanding emergency departments, hospital outpatient locations, and licensed health care professionals who bill for care in those places. Federally qualified health centers are excluded.

How to apply. Ask the hospital's financial assistance or billing office for a Hospital Discounted Care screening. The hospital must decide within 21 days of a complete application. You can appeal to the hospital in writing within 30 days, and then to HCPF at hcpf_HospDiscountCare@state.co.us or 303-866-2580. More information: https://hcpf.colorado.gov/colorado-hospital-discounted-care

> Patients who are at or below 250% of the Federal Poverty Guidelines (FPG) are eligible for Hospital Discounted Care.

Source https://hcpf.colorado.gov/colorado-hospital-discounted-care, checked 2026-11-11

## Notes

Uninsured patients in Colorado with income at or below 250% of the poverty level may owe nothing. Patients with insurance at that income level still pay a copay, $650 for a hospital stay or same-day surgery and $50 for an outpatient visit. The hospital counts savings and investments along with income, so assets can raise your calculated level. The bill under this policy will not be more than 25% of yearly income. Apply within 240 days of the first bill after you leave the hospital. Payment plans have no interest. Colorado's Hospital Discounted Care law also limits bills for Colorado residents at or below 250% of the poverty level, even with other coverage. Help with applying is at 888-347-3295 or CSFinancialAssistance.MtRegion@CommonSpirit.org. The posted policy is dated March 2024.

## Sources

- Free care level https://csdam.widen.net/s/7k58d7g55q/financial-assistance-policy
  > 100% reduction from gross charges without copay for the uninsured
- Free care level https://csdam.widen.net/s/gdtvggffsh/chadm-011-process-of-applying-for-financial-assistance
  > with a family income of up to 250% of the Federal Poverty Level, you may be eligible to receive a 100% discount.
- Discount level https://csdam.widen.net/s/gdtvggffsh/chadm-011-process-of-applying-for-financial-assistance
  > annual family income between 251%-400% of the Federal Poverty Level, you may be eligible to have your balance for services reduced
- Discount steps https://csdam.widen.net/s/gdtvggffsh/chadm-011-process-of-applying-for-financial-assistance
  > 0-250% $650 copay per visit $50 copay per visit 15% of charges 251% - 299% 10% of charges
- Co hospital discounted care https://csdam.widen.net/s/vvwkvdvlmr/hospital-discounted-care-patient-rights---co
  > If your gross household income is at or below 250% of the federal poverty guidelines
- Insured patients https://csdam.widen.net/s/7k58d7g55q/financial-assistance-policy
  > Insurance programs leaving a patient balance may be eligible for CommonSpirit Health Mountain Region financial assistance if the patient meets financial screening requirements.
- Asset test https://csdam.widen.net/s/7k58d7g55q/financial-assistance-policy
  > A patient’s Adjusted FPL will be calculated using the patient’s household income plus liquid assets and household family size.
- Residency https://csdam.widen.net/s/7k58d7g55q/financial-assistance-policy
  > Established residency in CommonSpirit Health Mountain Region's market service area is required, unless the visit is due to an urgent or emergent visit.
- Very large bills https://csdam.widen.net/s/7k58d7g55q/financial-assistance-policy
  > In addition to an income level evaluation as outlined above, the amount of patient responsibility will not exceed 25% of annual income.
- Deadline https://csdam.widen.net/s/7k58d7g55q/financial-assistance-policy
  > CommonSpirit Health Mountain Region will accept a FAA Form up to 240 days from the date of the first post-discharge statement.
- Documents https://csdam.widen.net/s/z2tgdtk2jp/financial-assistance-required-documentation
  > Proof of residency (2 required). i.e., phone or utility bill, rent receipts/lease, trash.
- Languages https://csdam.widen.net/s/7k58d7g55q/financial-assistance-policy
  > The FAP, FAA and PLS are available in English and Spanish.
- What is not covered https://csdam.widen.net/s/7k58d7g55q/financial-assistance-policy
  > Non-medically necessary services and procedures will not qualify for CommonSpirit Health Mountain Region's FAP.
- Covered facility https://csdam.widen.net/s/mvrvt6rhb2/addendum-a---covered-facilities
  > Longmont United Hospital
- Financial counseling phone https://csdam.widen.net/s/7fwnfrxpsz/addendum-d---hospital-counselor-locations
  > Longmont United Hospital 1950 Mountain View Avenue ... Financial Counseling: 303-651-5102

Last checked 2026-11-11.

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