Financial Assistance Program
At Madison County Health Care System, we offer financial assistance to all patients, no matter your background or circumstances. To find out if you qualify, we’ll check your household size and annual income using the Federal Poverty Guidelines. It’s important to know that financial assistance only covers services billed by Madison County Memorial Hospital. Some services, such as ambulance rides, prescriptions, specialty clinic providers and durable medical equipment (wheelchairs, walkers, oxygen equipment, insulin pumps, breast pumps, etc.) are not included.
We don’t discriminate against race, color, gender, sexual identity, age, handicap, religion, national origin, or political belief. Everyone is eligible for financial assistance if they meet the other criteria in Madison County Memorial Hospital’s Financial Assistance Program Policy.
To apply for assistance, you must:
- Complete application (download form or complete online)
- Provide proof of income for the past year (Federal Income Tax Return required)
- Be willing to explore all other payment options, including Medicaid and the Health Insurance Exchange
Applications should be returned to:
Business Office Manager
Madison County Memorial Hospital
300 W. Hutchings St.
Winterset, IA 50273
For more information, or assistance, please call (515) 462-9747, or email aford@madisonhealth.com
APPLY HERE: Online Financial Assistance Application
- Click here to download the Financial Assistance Form .
- Click here to download a copy of Information about Financial Assistance .