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Financial Assistance

Financial Assistance

Family Health West knows that paying for medical care can be difficult for many families. As part of Family Health West Hospital’s commitment to our patients, we provide counseling and assistance to help individuals apply for available programs that may help cover unpaid hospital bills.

  • Patients who are uninsured or underinsured may qualify for PEAK (Colorado Medicaid) or CICP (Colorado Indigent Care Program). We can provide the necessary information for you to apply for assistance.
  • If you are not eligible for PEAK or CICP, our Financial Counselor can discuss other options available to you, such as a discount at the time of service for self-pay patients or monthly payment plans.
I don't qualify for PEAK or CICP, how do I apply for medical financial assistance?

If you would like to apply for financial assistance, complete the application below. This application is also available from the Hospital Registration Department or from a Financial Counselor. Complete the form and return it as soon as possible.

How is eligibility for medical financial assistance determined?

Completing the application is not a guarantee that you will be approved for financial aid. We will review the details of your application which include current income, expenses, and family size. Be sure to sign the application, provide copies of the required documentation, and submit the application soon. You will be notified of our decision, in writing, within 30 days of receipt of the completed application.

What happens to my account while I'm applying for medical financial assistance?

The collection process will continue until your financial aid status is determined. Please make arrangements with our Financial Counselor as soon as possible.

Family Health West Hospital Application Forms