Sanford financial assistance: Fill out and sign online 2026

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How to use or fill out Sanford financial assistance: Fill out and sign online

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  1. Click ‘Get Form’ to open the Sanford financial assistance application in our platform.
  2. Begin by filling out the Demographics section. Enter your name, date of birth, and marital status. Ensure all fields are completed accurately.
  3. List all dependents under 18 living in your household, including their names and dates of birth.
  4. In the Insurance Information section, indicate whether you have insurance or are uninsured by checking the appropriate box.
  5. Provide your income details. Fill in the monthly gross income for yourself and your spouse across various sources such as employment, Social Security, and other incomes.
  6. Complete the Assets section by detailing account types, financial institutions, and their respective amounts or values.
  7. Attach required documents like tax returns and pay stubs using our editor's upload feature to ensure they accompany your application.
  8. Finally, review all information for accuracy before signing the application digitally within our platform.

Start filling out your Sanford financial assistance application online today for free!

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
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If you are facing financial hardship, we encourage you to apply to Medi-Cal or explore other government programs that may be of assistance. If you do not qualify for those programs, or if you have substantial financial liabilities despite having insurance, you may qualify for our financial assistance program.
Patients must have a family income at or below 400% of the federal poverty guidelines or demonstrate docHub financial hardship that prevents them from paying for care. You can find them through HealthCare.gov. You need to provide your name, address, phone number and account number (if available).
FAPs must apply to all emergency and medically necessary care furnished by the hospital and substantially related entities. If emergency and medically necessary care is provided by the hospital facility, the care must be covered under the FAP. Check for a Provider List.
1. A patient (or patient guarantor) with a household income of 225% or less of the Federal Poverty Level (FPL) is eligible for full financial assistance. 2. A patient (or patient guarantor) with a household income between 226% and 375% of the FPL is eligible for partial financial assistance on a sliding scale.
Medicaid and CHIP are considered federal financial assistance. Medicare Part A is also considered federal financial assistance. However, the receipt of Medicare Part B is not considered federal financial assistance. Medicare Part C and Part D are considered federal financial assistance.

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Opening Paragraph: Introduce Yourself and Your Situation Your opening paragraph should introduce yourself and explain your financial situation briefly. Be honest and transparent about your situation, but keep it concise.
If at any time you have questions regarding your Sanford Health billing statement, please contact our office at (877) 629-2999 or (800) 263-2237. Our Customer Service staff is ready to assist you.

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