Patient Services Guidelines
EMERGENCY ASSISTANCE FUND
PURPOSE: This service is intended as emergency assistance for essential medical and non-medical needs. Consideration will only be given after all other forms of assistance have been explored. Assistance is intended to supplement the cost of a particular need and not necessarily intended to cover the full cost . No financial assistance will be made for doctor or hospital bills.
GUIDELINES
Chronic Renal Failure (require dialysis or transplant to sustain life)
Live within service area of the Kidney Foundation of Northwest Ohio
Essential Medical Need
Transportation (medical purposes only)
Renal Medications (approved meds only)
Nutritional supplements
Medical Equipment
Maximum assistance amount: Up to $50.00 per year.
GENERAL FINANCIAL ASSISTANCE
PURPOSE: This service is intended as temporary assistance for transportation or medication needs. Consideration will only be given after all other forms of assistance have been explored. Assistance is intended to supplement the cost of a particular need and not necessarily intended to cover the full cost. No financial assistance will be made for doctor or hospital bills.
GUIDELINES
Chronic Renal Failure (require dialysis or transplant to sustain life)
Live within service area of the Kidney Foundation of Northwest Ohio
Eligibility is determined based on review of Financial Summary forms
Income at or below 150% of Poverty Guidelines as determined by the 2007 Federal Poverty Guidelines.
Monthly Income
Size of Family Unit |
2007 HHS Poverty Guidelines |
150% of Poverty Level
|
| 1 |
$797.50 |
$1,276.25 |
| 2 |
$1,069.17 |
$1,711.25 |
| 3 |
$1,340.83 |
$2,146.25 |
| 4 |
$1,612.50 |
$2,581.25 |
| 5 |
$1,884.17 |
$3,016.25 |
| 6 |
$2,155.83 |
$3,451.25 |
| 7 |
$2,427.50 |
$3,885.00 |
| 8 |
$2,699.17 |
$4,321.25 |
Essential Medical Need
Transportation (medical purposes only)
Renal Medications (approved meds only)
Nutritional Supplements
Medical Equipment
|
