Kettering hospital financial assistance 2026

1. Click ‘Get Form’ to open the Kettering Hospital Financial Assistance application in the editor.
2. Begin by entering your personal information, including your name, date of birth, and contact details. Ensure accuracy as this information is crucial for processing your application.
3. Fill in the dates of hospital service and answer the questions regarding Medicaid benefits and residency status. This section helps determine your eligibility for assistance.
4. Indicate your marital status and provide household size details. Include all members living with you who may affect financial calculations.
5. Report your monthly gross income from all sources. Be thorough in listing each type of income to ensure a complete assessment.
6. Answer questions about any changes in income over the past year and provide total gross family income for the previous three and twelve months.
7. Review your application for accuracy, then sign and date it. If someone else is signing on your behalf, include their details as well.
8. Submit your completed application along with proof of income via mail or email as instructed at the end of the form.

Start filling out your Kettering Hospital Financial Assistance application today using our platform for free!