Charity Care Policy

 

OVERVIEW:

The Queen’s Health Systems Hospitals (The Queen’s Medical Center at Punchbowl and West Oahu, Molokai General Hospital and North Hawaii Community Hospital) are committed to providing medical services to patients and objectively considers each patient’s financial ability to pay for the cost of hospital services.


Financial Assistance Policy (Charity Care)

The Financial Assistance Policy, also known as Charity Care, offers emergency and other medical necessary services at low or no cost to the patient. A discounted rate is applied to an eligible patient who does not have or cannot obtain adequate financial resources to pay for their medical care. Our staff will assist individuals, free of charge, in applying for eligible governmental health insurance programs, such as Medicare and Medicaid/ Quest. Upon approval of the Financial assistance application, individuals will receive a 100% or 65% discount. Applicants may be screened for Medicaid eligibility and requested to cooperate with applying for Medicaid-Quest.

 

Eligibility Requirements

Financial assistance is generally determined by a sliding scale of total household income based on Federal Poverty Guidelines for US citizens and US residents or based on country minimum wage annualized for non-US citizens and non-US residents.


How and Where to Obtain Information and Assistance Regarding Our Financial Assistance Policy

Please visit the Patient Access or Business Services offices at any of our hospitals where a representative will provide you with an application upon request. You may also contact a Patient Account Representative at (808) 691-5300, Monday through Friday from 8:00 a.m. to 4:30 p.m. at each hospital (addresses listed at the bottom of this sheet).

Applications are available at each hospital You may obtain a copy of the Financial Assistance Policy, financial assistance application and this plain language summary at each of the hospital’s websites:

 

The Queen's Medical Center

Molokai General Hospital

North Hawaii Community Hospital

 


Charity Care Policy:

Download

 

Exhibit B - Income Asset Qualifiers and Discount Rates:
Download

 

Exhibit C - Financial Assistance Application:
Download


Availability of Translations

Financial Assistance Application and Plain Language Summary are available in Japanese, Samoan, Vietnamese, Korean, Chinese, Tongan, Chuukese and Tagalog. 


Please return your completed application to the attention of Business Services at:

The Queen’s Medical Center Punchbowl, 1301 Punchbowl Street, Honolulu, Hawaii 96813
The Queen’s Medical Center West Oahu, 91-2141 Fort Weaver Road, Ewa Beach, Hawaii 96706
Molokai General Hospital, 280 Home Olu Place, Kaunakakai, Hawaii 96748
North Hawaii Community Hospital, 67-1125 Mamalahoa Highway, Waimea, Hawaii 96743

 

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