# Via Christi Hospital Wichita St. Teresa, Inc

Hospital in Wichita, KS. Verified from the hospital's own policy.

Via Christi Hospital Wichita St. Teresa, Inc 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 15% of the bill (85% discount)
- 301% to 350% of poverty level, patient pays 20% of the bill (80% discount)
- 351% to 399% of poverty level, patient pays 25% of the bill (75% discount)

## How to apply

- Call 800-298-8347 and ask for financial assistance.
- [Application form](https://healthcare.ascension.org/-/media/healthcare/financial-assistance/kansas/fap-application/runningfile_kswic_english_financial-assistance-application.pdf)
- [Financial Assistance Policy (July 1, 2025)](https://healthcare.ascension.org/-/media/healthcare/financial-assistance/kansas/fap/runningfile_kswic_english_financial-assistance-policy.pdf)
- [Plain language summary](https://healthcare.ascension.org/-/media/healthcare/financial-assistance/kansas/plain-language-summary/runningfile_kswic_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 Butler, Harvey, Sedgwick, Sumner or Kingman County, Kansas (the Wichita area). 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.

## Notes

Free care up to 250% of the poverty level, but approved patients still pay a small copay: $100 per emergency visit, observation stay or inpatient stay, and $25 per outpatient visit (outpatient rehab capped at $250). Discounts of 75% to 85% apply from 251% to about 400% of the poverty level. 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/kansas/fap/runningfile_kswic_english_financial-assistance-policy.pdf
  > Patients with income less than or equal to 250
- Free care level https://healthcare.ascension.org/-/media/healthcare/financial-assistance/kansas/fap/runningfile_kswic_english_financial-assistance-policy.pdf
  > will be eligible for 100% charity care on that portion of the charges for services for which the Patient is responsible
- Discount level https://healthcare.ascension.org/-/media/healthcare/financial-assistance/kansas/fap/runningfile_kswic_english_financial-assistance-policy.pdf
  > 351% - 399% FPL Base = 75% write off
- Discount steps https://healthcare.ascension.org/-/media/healthcare/financial-assistance/kansas/fap/runningfile_kswic_english_financial-assistance-policy.pdf
  > 251% - 300% FPL Base = 85% write off 301% - 350% FPL Base = 80% write off
- Discount level https://healthcare.ascension.org/-/media/healthcare/financial-assistance/kansas/fap/runningfile_kswic_english_financial-assistance-policy.pdf
  > Patients with incomes above 250
- Insured patients https://healthcare.ascension.org/-/media/healthcare/financial-assistance/kansas/fap/runningfile_kswic_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/kansas/fap/runningfile_kswic_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/kansas/fap/runningfile_kswic_english_financial-assistance-policy.pdf
  > Financial assistance described in this section is limited to Patients that live in the Community
- Residency https://healthcare.ascension.org/-/media/healthcare/financial-assistance/kansas/fap/runningfile_kswic_english_financial-assistance-policy.pdf
  > The five counties include Butler, Harvey, Sedgwick, Sumner and Kingman.
- Residency https://healthcare.ascension.org/-/media/healthcare/financial-assistance/kansas/fap/runningfile_kswic_english_financial-assistance-policy.pdf
  > the catchment area will be waived for that date of service only.
- Very large bills https://healthcare.ascension.org/-/media/healthcare/financial-assistance/kansas/fap/runningfile_kswic_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/kansas/fap/runningfile_kswic_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/kansas/fap/runningfile_kswic_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
- Documents https://healthcare.ascension.org/-/media/healthcare/financial-assistance/kansas/fap-application/runningfile_kswic_english_financial-assistance-application.pdf
  > Copies of 3 most recent paystubs from employer
- Covered facility https://healthcare.ascension.org/-/media/healthcare/financial-assistance/kansas/fap/runningfile_kswic_english_financial-assistance-policy.pdf
  > Ascension Via Christi St. Teresa

Last checked 2026-11-11.

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