Novant Health UVA Health System Prince William Medical Center & Novant Health UVA Health System Haymarket Medical Center
Novant Health UVA Health System Prince William Medical Center and Haymarket Medical Center will provide financial assistance for patients who receive medically necessary services and meet the eligibility requirements under the Charity care policy, available below under each language heading. If eligible for financial assistance, patients will receive a 100% discount or free care. The financial assistance program does not cover elective services.
How do I apply?
Below, financial assistance applications are available in English and several other languages, including other helpful resources and policies. Be sure to follow the Instructions on the financial application form for submitting your completed application.
Am I eligible?
In order to qualify for financial assistance, the patient must:
- Be uninsured or, in certain circumstances, have limited insurance coverage
- Be unable to access other programs that would cover medical expenses
- Not have substantial cash assets
- Not have declined health insurance through an employer
- Not be ineligible for government sponsored coverage because of noncompliance with requirements
- Be considered medically necessary (generally defined as urgent or emergent)
- Live in the medical center's service area
- Not have an annual family income of 300% of current federal poverty guidelines.
- Submit application and supporting documents to the hospital business office or financial counseling department
How will I know if I've been approved?
Once all requested documents are received the application will be reviewed. An approved or denial letter will be mailed. This documentation must be updated every six months, or when the patient's income or circumstances change. Each visit within the six month period will be reviewed for potential access to other programs.
This policy only applies to services rendered at Novant Health UVA Health System Prince William Medical Center or Haymarket Medical Center. It does not apply to services rendered by any independent physicians or practitioners that are not employed by Novant Health UVA Health System. This includes, but is not limited to, anesthesiologists, radiologists and pathologists.
Novant Health UVA Health System Prince William Medical Center
8700 Sudley Road
Manassas, Va 20110
Novant Health UVA Health System Haymarket Medical Center
15225 Heathcote Boulevard
Haymarket, VA 20169
Financial assistance documents