Plain Language Summary of Financial Assistance Policy



It is the policy of Spooner Health (SH) to treat the broadest number of patients residing within our service area while maintaining fiscal responsibility. This is a summary of the SH Financial Assistance Policy (FAP).

Availability of Financial Assistance

Patient will be considered for charity or discounted billing based on their ability to pay and the Federal Poverty Level Guidelines (FPG) issued and updated annually. Charity consideration is given to emergency, inpatient, outpatient and medically necessary procedures. Financial assistance and discounts only apply to SHS bills.
Any balance can be considered for charity, including balances after insurance payment. Patients must reside within the State of Wisconsin.

Eligibility Requirements 

Financial assistance is generally determined by a sliding scale of total household income based on FPG. With respect to uninsured individuals, the following table applies:

Total Household Income Discount from Gross Charges
Less than 100% of FPL 100% discount
Between 101% and 150% of FPL  90% discount
Between 151% and 200% of FPL  75% discount
Between 201% and 250% of FPL  50% discount
Between 251% and 300% of FPL  41% discount

No person eligible for financial assistance under the FAP will be charged more for medically necessary care than amounts generally billed (AGB) to individuals who have insurance covering such care. SH determines AGB based on all claims paid in full to SH by Medicare and private health insurers (including payments by Medicare beneficiaries or insured individuals themselves), over a 12-month period, divided by the associated gross charges for those claims. If an individual has sufficient insurance coverage or assets available to pay for care, he/she may be deemed ineligible for financial assistance. Please refer to full policy for a complete explanation and details.

Where to Obtain Information

There are numerous ways that an individual may obtain information about the FAP application process, or obtain copies of the FAP or FAP Application Form:

  • Download the information online at

  • Request the information by telephone by calling the Spooner Health Patient Accounts Financial

    Counselor at 715-939-1609

  • In person at Spooner Health, 1280 Chandler Drive Spooner, WI 54801

Availability of Translations

The FAP, FAP Application Form, and this plain language summary shall be prepared in English and for any population more than either (a) 1,000 individuals or (b) 5% of the community served by the hospital.

How to Apply

The application process involves filling out the Financial Assistance form and mailing the form along with the supporting documentation to SH for processing. You may also apply in person by visiting the Patient Accounts Department at the address listed below. Financial Assistance applications are to be submitted to the following office:

Spooner Health
Attn: Patient Financial Counselor 1280 Chandler Drive Spooner, WI 54801-2202

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