Pay Your Bill

Charity Payment

Notification of Charity Care Program
 
  
Dear Patient:
 
Margaret Mary Community Hospital has restricted charity care funds available for the inpatient and outpatient services throughout the year.  This is a self-funded program through the hospital and is allocated on a first come, first serve basis.  If you feel you qualify, please complete the attached application and return it to the Business Office of the hospital.
 
You will need to attach the completed application along with verifiable information as to your household income.  We will need copies of any W-2 forms you may have received during the last calendar year, a copy of your most recent income tax return, copies of any checks you receive as income (including disability, compensation, unemployment, etc.), the name of your case worker if you are receiving any public assistance from the county and any other data that you feel would aid in the processing of your application.
 
Should your application be considered, you may qualify for a partial or full reduction on your outstanding account(s) with our hospital.  Please address any questions you may have with your patient account representative at Margaret Mary Community Hospital within the Business Office.
 
Donna M. Metz
Business Office Manager
(812) 934-6624, ext. 1141

For a Charity Care Application, click here.

For a Charity Care Schedule, click here.