# Mercy Health - West Hospital

Hospital in Cincinnati, OH. Verified from the hospital's own policy.

Mercy Health - West Hospital 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 $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 | $31,920 | $63,840 |
| 2 | $43,280 | $86,560 |
| 3 | $54,640 | $109,280 |
| 4 | $66,000 | $132,000 |
| 5 | $77,360 | $154,720 |
| 6 | $88,720 | $177,440 |

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 21% of charges (79% discount)
- 301% to 400% of poverty level, patient pays 21% of charges (79% discount)

## How to apply

- Call 1-855-732-0138 and ask for financial assistance.
- [Application form](https://www.mercy.com/-/media/mercy/patient-resources/financial-assistance/2024/english/mercy-health-2024-application_final_clean.pdf)
- [Healthcare Financial Assistance (HFA) Policy, Policy 502 (effective March 1, 2026)](https://www.mercy.com/-/media/mercy/patient-resources/financial-assistance/hfa-policy-502/english.pdf)
- [Plain language summary](https://www.mercy.com/-/media/mercy/patient-resources/financial-assistance/plain-language-summary_mercy-health_final_clean.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 proof of income for each household member (3 or 12 months), tax forms with Schedule C if self-employed, benefit letters for unemployment, Social Security, pension or disability, court order for child support, current 30-day statement for each checking or savings account, copy of insurance card if insured.
- Residency. Must live in the community the hospital serves. Others need documented extenuating circumstances and emergency or medically necessary care.
- Very large bills. Medical or hospital bills left after insurance that are more than 25% of income
- Languages. English, Arabic, Cambodian, Cantonese, Dari, French, Gujarati, Haitian Creole, Hindi, Korean, Mandarin, Nepali, Pashto, Portuguese, Punjabi, Russian, Spanish, Swahili, Uzbek, Vietnamese

## 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.

Not covered. Care that is not medically necessary. Mercy Health Medical Group doctor offices and urgent care centers have their own separate policies.

## State program in Ohio

### Hospital Care Assurance Program (Ohio Revised Code 5168.14 and Ohio Administrative Code 5160-2-17)

Ohio law says hospitals that get state Hospital Care Assurance Program (HCAP) funds must give basic, medically necessary hospital care free of charge to some patients. You may qualify if you live in Ohio, are not on Medicaid, and your household income is at or below the federal poverty level (100%). The law covers general medical and surgical hospitals and children's hospitals. It does not cover transplants. You must fill out and sign an application with proof of income and family size. Many people at this income can also get Medicaid, so the hospital may ask you to apply for it. HCAP covers only the hospital's own bill. Doctors who bill separately are not covered. Many hospitals offer more help than this under their own policy, so ask about both.

Income levels in the program are free up to 100% of poverty level.

Applies to nonfederal Ohio hospitals registered as general medical and surgical or pediatric general hospitals (and Medicare-recognized cancer hospitals) that receive HCAP funds; Ohio residents who are not Medicaid recipients.

How to apply. Ask the hospital's billing or financial assistance office for an HCAP application. Fill it out, sign it, and include proof of your income and family size. Hospitals must post signs about HCAP in admissions, the business office, and the emergency room.

> shall provide, without charge to the individual, basic, medically necessary hospital-level services

Source https://codes.ohio.gov/ohio-revised-code/section-5168.14, checked 2026-11-11

## Notes

Free care at or below 200% of the poverty level. From 201% to 400%, this hospital takes 79% off the bill (2026 chart, updated each year). Insured patients can get the same sliding discount on what they owe after insurance, such as deductibles, copays and coinsurance. Uninsured patients who do not meet the income limits get an automatic 40% self-pay discount. Some patients get free care without income proof, for example people on food stamps, WIC, school lunch, Medicaid spend-down, or who are homeless. If bills after insurance are more than 25% of income, help may still be available. Mercy may ask you to apply for Medicaid first. An approval covers care for 240 days from the first date of service. The policy does not state a deadline to apply. Assets may be reviewed when little or no income is reported. Patient Financial Services is 1-855-732-0138. The financial assistance web page lists 877-918-5400 for questions. Mail applications to Mercy Health Public Benefits Dept, PO Box 631774, Cincinnati, OH 45263-1774. Ohio residents at or below the poverty line who are not on Medicaid may get basic hospital care free through Ohio's Hospital Care Assurance Program (HCAP). Ohio requests are checked for HCAP first.

## Sources

- Free care level https://www.mercy.com/-/media/mercy/patient-resources/financial-assistance/hfa-policy-502/english.pdf
  > Individuals with an income level at 200% FPG or below receive free care.
- Discount level https://www.mercy.com/-/media/mercy/patient-resources/financial-assistance/hfa-policy-502/english.pdf
  > HFA eligibility is based upon expanded income levels of up to 400% of FPG and is prorated on a sliding scale
- Discount steps https://www.mercy.com/-/media/mercy/patient-resources/financial-assistance/hfa-policy-502/english.pdf
  > Mercy Health - West Hospital 100% 79% 79% 40%
- Insured patients https://www.mercy.com/-/media/mercy/patient-resources/financial-assistance/hfa-policy-502/english.pdf
  > balances attributed to the patients’ deductible (including co-pay and co-insurance amounts) will require payment based on a sliding scale
- Residency https://www.mercy.com/-/media/mercy/patient-resources/financial-assistance/hfa-policy-502/english.pdf
  > Patients who live in the community served by BSMH Healthcare Facilities will be offered HFA.
- Very large bills https://www.mercy.com/-/media/mercy/patient-resources/financial-assistance/hfa-policy-502/english.pdf
  > medical or hospital bills after payment by all third parties that exceed 25% of the patient's total Reported Income
- Covered facility https://www.mercy.com/-/media/mercy/patient-resources/financial-assistance/hfa-policy-502/english.pdf
  > Mercy Health - West Hospital
- Financial counseling phone https://www.mercy.com/-/media/mercy/patient-resources/financial-assistance/plain-language-summary_mercy-health_final_clean.pdf
  > contacting Bon Secours Mercy Health Patient Financial Services by telephone at 1-855-732-0138
- Documents https://www.mercy.com/-/media/mercy/patient-resources/financial-assistance/2024/english/mercy-health-2024-application_final_clean.pdf
  > FOR INCOME ASSETS LISTED ABOVE YOU MUST PROVIDE THE FOLLOWING FOR EACH MEMBER OF THE HOUSEHOLD
- Approval period https://www.mercy.com/-/media/mercy/patient-resources/financial-assistance/hfa-policy-502/english.pdf
  > Approved applications will be honored for a period of 240 days from the initial date of service
- Assets https://www.mercy.com/-/media/mercy/patient-resources/financial-assistance/hfa-policy-502/english.pdf
  > BSMH may evaluate and require documented proof of any assets that are categorized as convertible to cash
- Self pay discount https://www.mercy.com/-/media/mercy/patient-resources/financial-assistance/hfa-policy-502/english.pdf
  > BSMH extends an automatic (self-pay) discount to their hospital bills as outlined on Attachment 2.
- Ohio hcap https://www.mercy.com/-/media/mercy/patient-resources/financial-assistance/hfa-policy-502/english.pdf
  > BSMH provides, without charge to the individual, basic, medically necessary hospital-level services to individuals who are residents of Ohio

Last checked 2026-11-11.

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