A financial assistant helping a couple

Financial Assistance

Financial Assistance

As a community-based, not-for-profit healthcare system, it is Lima Memorial’s mission to provide high-quality healthcare services to anyone who needs it, regardless of their ability to pay.

Our billing representatives are more than happy to work with you to create a payment plan for your account. You can apply for financial assistance through the Ohio Hospital Care Assurance Program (HCAP) by completing our online form.

Click here to download the HCAP form.

Once you complete the form, please print, sign, include your Medicaid eligibility denial and return it to:
Lima Memorial Patient Accounts Department
1001 Bellefontaine Avenue
Lima, OH 45804

Click here to download the Summary of Financial Assistance

Click here to download the Hospital Financial Assistance, Billing and Collections Policy

The Hospital Care Assurance Program (HCAP)

The Hospital Care Assurance Program (HCAP) is the Ohio Department of Job and Family Services’ mechanism to meeting the federal requirement to provide additional payments to hospitals that provide a disproportionate share of uncompensated services to the indigent and uninsured.

For hospital services provided by Lima Memorial Health System on or after May 22, 1992, a person may be eligible for basic medically necessary hospital services at no charge if their income is at or below the federal poverty guidelines in accordance with Ohio Revised Code (occurred) section 5112.17. Any account that has occurred within the last three years may be eligible for the HCAP program based on the patient’s income and family size.

Financial Statement Application for Monthly Payments

As a service to our patients, Lima Memorial offers payment plans for those who are unable to pay their balance in full. To see if you are eligible to extend a payment contract longer than 24 months, please fill out the following form (balances must be more than $2,000 to be eligible).

Click here to download the Financial Statement Application for Monthly Payments form.

Once you complete the form, please print, sign and return it to:
Lima Memorial Financial Services Department - FA
1001 Bellefontaine Avenue
Lima, OH 45804

Questions? Call Lima Memorial Patient Accounts Department at 419-226-5040.

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