Financial Assistance 2017-12-29T10:09:23+00:00

Financial Assistance

Rio Grande Hospital and Clinics are dedicated to providing medically necessary health care services; these services are accessible to all, regardless of age, gender, geographic location, cultural background, physical mobility, or ability to pay. We are committed to providing health care services and acknowledge that in some cases the patient will not be financially able to pay for the services received. In those particular cases the patient will be screened, and a determination of eligibility for financial assistance will be initiated prior to or at the time of admission.

Download the Financial Assistance Guidelines & Policies

Sliding Fee Scale Assistance Available

National Health Service Corps Promise – English

National Health Service Corps Promise – Spanish

Download Financial Assistance Guide – English

Download Financial Assistance Guide – Spanish

Federal Poverty Guidelines Sliding Fee Scale 2018

Medicaid Assistance

What is Medicaid?

Medicaid is free or low cost public health insurance for Coloradans who qualify. Medicaid can cover your doctor visits, emergency care, preventive care such as screenings and immunizations, and other procedures and treatments.

Who is Eligible?

Financially qualified children ages 0-18 and parents with dependent children

Parents whose income is at or below 133% of the Federal Poverty Level

Children age 6-18 whose family income is at or below 133% of the Federal Poverty Level

Pregnant women at or below 195% of the Federal Poverty Level

Medicaid Monthly Maximum Income Guidelines

Effective April 1, 2015

Family
Size
Parents and
Caretaker Relatives
68% Poverty Level *
Adults
(Ages 19-65)
133% Poverty Level
Children
(Ages 0-18)
142% Poverty Level
Pregnant Women
195% Proverty Level
1
667
1,305
1,393
1,913
2
903
1,766
1,886
2,587
3
1,139
2,227
2,378
3,265
4
1,375
2,688
2,870
3,941
5
1,610
3,149
3,362
4,617
6
1,846
3,610
3,855
5,293
7
2,082
4,071
4,347
5,969
8
2,318
4,532
4,839
6,645
9
2,553
4,994
5,331
7,321
10
2,789
5,455
5,824
7,997
Co-payments may apply; no co-pays for American Indians, Alaska Natives or pregnant women and her household.
*To align with federal policy, effective April 1, 2015, the Parents and Caretaker Relative maximum FPL has been changed from 107% to 68% FPL. For more information to go www.colorado.gov/HCPF

How to Apply

Rio Grande Hospital is now an application assistance site for Colorado residents seeking to apply for Medicaid. Come in and inquire at the admissions desk or you may call 719-657-2510 ext. 1063 to speak with Monica Ware.

For more information please visit www.colorado.gov/hcpf

Colorado Indigent Care Program

Requirements for Colorado Indigent Care Program

To schedule a Colorado Indigent Care Program (CICP) rating interview with Monica Ware, call 719-657-4063. You must bring the following information with you at the time of your interview

Residency, Identification, and Citizenship:

  • State of Colorado Driver’s License or Colorado Picture I.D., Military I.D. for all household member’s 18 years and older
  • Furnish a Social Security Number
  • Proof of Citizenship

Gross Earned Income for Household:

  • Most recent paystubs for self and spouse
  • Most recent Profit/Loss ledger or Business Bank Statements for self-employment

Unearned Income:

  • Social Security or Disability Award Letter (SSDI), unemployment award letter, rental income, Workman’s Compensation, spousal maintenance, pensions, settlements, scholarships, bonuses (note: include spouse’s income as well)
  • Provide written proof of all other income not listed

Other Verification:

  • All medical/pharmacy/dental receipts or statements
  • Copy of Health Insurance card
  • Proof of payment on health insurance premiums
  • Current statement for all checking and savings accounts
  • Registration or titles for all vehicles and proof of loan balance if applicable
  • Verification of all CD’s, Annuities, Stocks, and Bonds
  • Verification of paid child support and childcare

To schedule an appointment call Monica Ware at 719-657-2510 ext. 1063
310 County Rd. 14 Del Norte, Co 81132

How to Apply

You can download the CICP (Colorado Indigent Care Program) Application below:

Download the CICP Application

Download the CICP Ability to Pay Scale