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Free Care

Maine Law requires that Free Care must be provided to Maine residents with income less than 150% of the federal poverty level. MaineHealth provides Free Care to all patients at 175% of the poverty level.

Our Free Care Program is based on family size and gross annual income. For example, if you have a family size of 3 and your gross annual income is less than $35,280 you would be eligible for 100% Free Care. See guidelines below:

VIEW THE AMOUNT GENERALLY BILLED CALCULATION DOCUMENT

VIEW THE FCHN BILLING & COLLECTION SUMMARY

The below list of employed providers accept determination of financial assistance by FCHN. Not all providers are employed by FCHN and may not accept our determination of financial assistance. Please be sure to check with your provider's office to validate their acceptance of our financial assistance determination.

VIEW THE LIST OF FCHN EMPLOYED PROVIDERS

To apply for free care you can complete the application, by printing from the website or contacting Patient Financial Services to request an application.

You will be asked to provide proof of insurance of any kind to help pay for your care. You may also be asked to show that insurance or a government program will not pay for your care.

Only medically necessary care is provided as Free Care.

If it has been determined that you do not qualify for Free Care, you may ask for a fair hearing. Please contact Patient Financial Service department and they will provide instructions on how to apply for a fair hearing.

You may be referred to the Department of Health and Human Services to apply for MaineCare based on your level of income and /or the type of services you received. (MaineCare may cover some of your medical bills). A Financial Counselor will advise you if you need to apply for MaineCare.

You can print the application for Free Care and mail your completed form with proof of income to:

FMH Financial Services Office
111 Franklin Health Commons
Farmington, ME 04938

If you have any questions or would like to schedule an appointment, please contact our Financial Services office at (207) 779-2777 or toll free at (888) 952-2772.

VIEW AND PRINT A Free Care application.

DOWNLOAD A COPY OF OUR FREE CARE POLICY

VIEW INFORMATION ON REQUESTING A FAIR HEARING

111 Franklin Health Commons, Farmington, ME 04938 - (207)-778-6031