Financial Assistance

Registration employee explaining information to patient

Faith Regional Health Services is a nonprofit healthcare organization that offers services throughout northeast Nebraska treating patients, regardless of their financial status. We can offer you financial assistance for these services in the form of discounted care if you qualify and have difficulty paying your medical bills with us.

Patient Financial Assistance Policies

Patient Financial Assistance Policy (English)

Patient Financial Assistance Policy (Spanish)

Collections Policy (English)

Collections Policy (Spanish)

Applying for Financial Assistance

In order to be considered for financial assistance, you need to complete an application and provide information that supports your financial need. In reviewing the application, we will consider the following factors:

  • Have all means of payment, such as private insurance coverage or coverage through Medicare, Medicaid, or other government programs, been exhausted?
  • Are there other circumstances or resources that may affect your ability to pay for care?
  • What is your family's gross income as it compares to the most recently published Federal Income Guidelines?
  • What is the size of your family?

Please use our Financial Assistance Checklist to help you through the application process. The Financial Assistance checklist is also available in Spanish.

Faith Regional Financial Assistance Applications

Complete the application below to be considered for financial assistance.

English Version Spanish Version


For questions regarding Financial Assistance please contact one of the following Financial representatives:

  • If your last name begins with A-H, please call (402) 644-7331
  • If your last name begins with I-P, please call (402) 644-7366
  • If your last name begins with Q-Z, please call (402) 844-8320

Additional Financial Assistance Programs and Applications

First Source

Faith Regional Health Services provides a free service to help you determine your eligibility for public benefits programs if you are uninsured. These are federal, state, county, or local programs designed to provide you financial aid if you are unable to meet your financial obligations related to your hospital stay. Examples of these types of programs include Supplemental Security Income, Medicaid, and County Medical Programs. Assistance with Health Care Reform insurance process is also available. There are differences among public benefits programs such as eligibility criteria, funding, and duration of services.

Our First Source representative will ask you for information on the medical services provided for you at Faith Regional, your income, your family size, and your citizenship to determine the program best suited for you. All completed applications are forwarded to the appropriate government agency that will determine your eligibility for the program, at no cost to you. Our First Source representative will track your application until a decision has been made. To learn more and get connected to a First Source representative, please call (402) 644-7566.

Every Woman Matters Program

Every Woman Matters is a program offered through the Nebraska Department of Health and Human Services that can help you if you are a woman between the ages of 40 and 74 pay for certain health check-ups, including screening mammograms.


Medicaid is a federal and state program that provides assistance to people with limited financial resources. This program is for children and teens age 18 and under and for pregnant women with a gross monthly family income at or below set amounts, assets are not counted. This program is also for parents living with their children and teens age 18 and under with a monthly income at or below set amounts and with certain assets of $2,000 or less.

Contact the Billing Department

Call us at (402) 844-8052


The Federal Health Insurance Marketplace Open Enrollment period begins in October every year. To find the exact dates of open enrollment


Faith Regional has contracted with First Source to help you navigate your coverage options. You can call them at (402) 644-7566 for assistance or questions.