Huntsville Hospital 101 Sivley Rd, Huntsville, AL 35801 Huntsville Hospital for Women & Children 245 Governors Dr, Huntsville, AL 35801 Madison Hospital 8375 Highway 72 W, Madison, AL 35758 For assistance completing the application or clarification on the guidelines; you may contact a financial Huntsville Hospital is a 971-bed hospital that serves as the regional referral center for North Alabama and southern Tennessee. HMH Financial Assistance – Walker County Indigent Care. Huntsville Hospital Foundation is dedicated to serving you -- our patients, hospital employees and community -- during this time of crisis. If you are in need of services at Huntsville Memorial Hospital and you are without health care coverage or have financial challenges, please print and complete a copy of the Texas Form 100.pdf and return the application to the Huntsville Memorial Hospital Financial Department within 30 days of your visit. Madison Hospital is a member of Huntsville Hospital Health System. One of the ways we fulfill this mission is to provide financial assistance to those members of the community in need. For a copy of the hospital’s Financial Assistance policies and Plain Language Summary, click here. Contact Madison Hospital Departments by phone including Billing, Medical Records, Patient Family Representative, and instructions for calling patient rooms. Applicants will be notified by letter regarding their financial assistance application status. Applicants will be notified by letter regarding their financial assistance application status. One of the ways we fulfill this mission is to provide financial assistance to those members of the community in need. We will determine financial assistance eligibility based upon income and asset guidelines and the Federal Poverty Income Guidelines. Approved applications apply to Huntsville Hospital Health System accounts only. These clinics have helped provide testing throughout north Alabama. Huntsville Hospital is committed to providing quality health care that improves the health of those we serve.

Our Financial Assistance Program may be able to assist with expenses for your care. We will determine financial assistance eligibility based upon income and asset guidelines and the Federal Poverty Income Guidelines. Our Financial Assistance Program may be able to assist with expenses for your care. Walker County Texas assistance programs. Financial assistance policies Financial Assistance approvals extend only to services provided by Huntsville Memorial Hospital and Clinic (see HMH Billing Disclosure). Many of our gifts such as baby items, gift cards, stuffed animals and balloons are also available online . Approved applications apply to Huntsville Hospital Health System accounts only. Huntsville Hospital for Women & Children offers the most advanced pediatric health care in the region including pediatric emergency services, pediatric intensive care, level III neonatal intensive care and pediatric surgery. How can I qualify?

We are now a 90-bed hospital and can grow alongside the community … up to about 200 beds. We are also home to one of only eight St. Jude Children's Research Hospital Affiliate Clinics in the nation.

Financial Assistance Huntsville Hospital is committed to providing quality health care that improves the health of those we serve. With clinics located across Texas, Huntsville Memorial Hospital is proud to provide innovative health services.
Church assistance received_____ _____ Bank loan Name: _____ pmt_____ Other income/$ received_____ Other expense: _____ pmt_____ Applicant’s statement: I do hereby certify that the information on this form is correct and true to the best of my knowledge & that no pertinent items of information have been concealed or omitted from this application. As a not-for-profit health care provider, all revenue is reinvested to provide advanced medical services and equipment. HMH Financial Assistance Speak with Us about Affordable Healthcare in Walker County. Huntsville Hospital is governed by the Health Care Authority of the City of Huntsville and is the second-largest hospital in Alabama. Organizational Guidelines Title: Financial Assistance Policy Department: Revenue Cycle Area: Hospital Wide Effective Date: November 1, 2015 Pages: 10 Date Last Revised/Reviewed: Approved by: System CFO Reference Number: ADM.045.08 Original Date Approved: November 1, 2015 Inactive Date: Purpose Huntsville Hospital’s guideline is to provide medically necessary health care services for …