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Financial Assistance

Financial Assistance

We understand patients may have concerns regarding the cost of healthcare and treatments. 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 PDF form below. 

Once you complete the form, please print, sign and return it to: 

Lima Memorial Patient Accounts Department
1001 Bellefontaine Avenue
Lima, OH 45804

Download Lima Memorial Summary of Financial Assistance

Download Lima Memorial Hospital Financial Assistance, Billing and Collections Policy

Federal Poverty Guidelines

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.

Download the HCAP / Charity Application Form

Questions? Call Lima Memorial Patient Accounts Department at 567-242-0460.

You will need Adobe® Acrobat® Reader to view PDF documents. Download a free copy from the Adobe Web site.