Financial Assistance Program
Having trouble paying for your Maui Health System medical expenses?
Maui Health System is committed to providing programs that facilitate access to care for vulnerable populations. This commitment includes providing financial assistance to qualified low income, uninsured, and underinsured patients when the ability to pay for services is a barrier to accessing emergency and medically necessary care. Patients must meet the eligibility requirements below to qualify.
Who is eligible for Financial Assistance and what are the requirements?
The Maui Health System financial assistance program helps low-income, uninsured, or underinsured patients who need help paying for all or part of their medical care received from Maui Health System. Patients are eligible for financial assistance when their family income is at or below 250% of the Federal Poverty Guidelines (FPG). Patients should consult with a counselor to determine eligibility and for assistance applying. Patients who have experienced unusually high medical expenses may be eligible for the program, regardless of household income. Refer to the Maui Health System Financial Assistance Policy for a complete description of the program eligibility requirements.
What does the program cover?
The Maui Health System financial assistance program covers emergency and medically necessary health care services, pharmacy services and products, and medical supplies provided at Maui Health System facilities or by providers that are subject to the Maui Health System financial assistance policy. Services that are not considered emergent or medically necessary as determined by Maui Health System include, but are not limited to cosmetic surgery or services, retail medical supplies, and services related to third party liability, or workers’ compensation cases. Refer to the Maui Health System Financial Assistance Policy for a complete list of eligible and ineligible services.
Which Providers are and are not covered under the program?
The list of providers in Maui Health System facilities that are and are not covered under the Maui Health System Financial Assistance Policy can be found in our provider list.
How can I get program information?
Copies of the Maui Health System financial assistance policy, application forms, instructions, and plain language summaries (e.g., policy summaries or program brochures) are available to the public, without charge, from our website, by email, in person, by telephone, or by U.S. postal mail.
Download program information: Electronic copies of program information are available
Request program information electronically: Electronic copies of program information are available by email upon request. Call Maui Health System at 808-565-8456 to request electronic copies. Please be prepared to provide an email address that the information can be sent to when calling.
Obtain program information in person: Program information is available from the Patient Financial Services Department at Maui Memorial Medical Center or the Patient Registration / Admitting Departments at the Kula and Lanai Hospitals.
Maui Memorial Medical Center: Patient Access Services Department
Kula Hospital: Business Office
Lana’i Community Hospital: Business Office
Request program information by telephone: Financial counselors are available by telephone to provide information and assist patients Monday – Friday, 8:30 a.m. – 4:30 p.m. at 808-565-8456.
Request program information by mail: A patient can request program information by mail. Information requests can be mailed to:
Maui Health System – Lana’i Community Hospital
Attention: Financial Counseling Services
P.O. Box 630650
Lanai City, HI 96763
How do I apply?
A patient can apply for financial assistance, during or following the care received from Maui Health System, in several ways including in-person with a financial counselor, or by submitting a complete paper application.
Apply in person: Financial counselors are available at Maui Health System facilities to quickly determine financial assistance eligibility. Financial counselors are available at the Business Department in each of the following Maui Health System facilities:
Maui Memorial Medical Center
Kula Hospital
Lanai Community Hospital
Complete and submit a program application: Please mail your completed application or deliver it in-person (including all required documentation and information specified in the application instructions) to:
Maui Health System – Lana’i Community Hospital
Attention: Financial Counseling Services
P.O. Box 630650
Lanai City, HI 96763
Maui Health System will review submitted applications when they are complete and will determine whether you are eligible according to the Maui Health System Financial Assistance Policy. Incomplete applications may result in a delay in processing or denial of your financial assistance application, but Maui Health System will notify applicants and provide an opportunity to send in the missing documentation or information, by the required deadline.
Amounts Generally Billed (AGB)
Amounts Generally Billed (AGB) is based on the lowest average of the amounts that were paid to a Maui Health Systems (MHS) facility by private health insurers, Medicare fee-for-service and Medicaid fee-for-service (and co-pays and deductibles) for emergency or medically necessary services, based on actual claim data from November 1, 2018 to October 31, 2019, which is consistent with the look-back method. Total expected payment from allowed claims was divided by total billed charges for such claims, and that number was subtracted from 1 to calculate the AGB percentage. The 2020 AGB reduction to gross charges is 60% for hospital charges.
Is there language assistance?
Interpreters are available to you at no cost. The Maui Health System financial assistance application, policy, and the policy summary may be available in your language. For more information, call 808-393-7060.
Other beneficial programs and extra resources:
If you don’t have health care coverage and would like more information, visit healthcare.gov or call 1-800-318-2596.
Need Help?
For help or questions about the Maui Health System financial assistance application process or other questions, please call 808-242-2495 or 808-442-5655, or speak to a financial counselor within the Patient Financial Services department at the Maui Health System hospital.
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