Financial Assistance
Learn more about available financial assistance options and policies to help you pay your health care bill.
Apply for Financial Assistance
If you are experiencing financial challenges or are unable to pay your health care bill in full, we’re here to help. University of Vermont Health offers a range of financial assistance options so you can continue to access the care you need, when and where you need it.
To apply for financial assistance, please select the hospital where you receive care from the list below and complete the forms. Please include the requested supporting documentation found on the application. Mail or fax the completed application and supporting documentation to:
University of Vermont Medical Center
Financial Assistance Program
Patient Access Department IDX 22052
111 Colchester Avenue
Burlington, VT 05401
You may fax the completed forms to 802-847-7618.
Once we have received all of the required documentation, we can complete your application within two weeks. If you need help completing the application, please contact UVM Health's financial assistance office at 802-847-8000 or toll-free at 800-639-2719.
University of Vermont Medical Center
Download and complete the following documents:
Central Vermont Medical Center
Download and complete the following documents:
Champlain Valley Physicians Hospital
Elizabethtown Community Hospital
Alice Hyde Medical Center
Porter Medical Center
Download and complete the following documents:
Home Health & Hospice
Please contact us to learn more about financial assistance programs at Home Health & Hospice.
By phone
In-person
Home Health & Hospice
1110 Prim Road
Colchester, VT 05446
Financial Assistance Policies
UVM Health is committed to providing financial assistance to patients who are uninsured, underinsured, ineligible for a government program or otherwise unable to pay for medically necessary care. Please review our policies by selecting the hospital where you receive care.
University of Vermont Medical Center
- Financial Assistance Policy Summary
- Financial Assistance Policy
- Credit and Collection Policy
- Income/Asset Guidelines
- Frequently Asked Questions (VT)
If you qualify for financial assistance, UVM Health cannot charge you more than the amounts generally billed to individuals with health insurance.
Central Vermont Medical Center
- Financial Assistance Policy Summary
- Financial Assistance Policy
- Credit and Collection Policy
- Income/Asset Guidelines
- Frequently Asked Questions (VT)
If you qualify for financial assistance, UVM Health cannot charge you more than the amounts generally billed to individuals with health insurance.
Champlain Valley Physicians Hospital
Elizabethtown Community Hospital
Alice Hyde Medical Center
Porter Medical Center
- Financial Assistance Policy Summary
- Financial Assistance Policy
- Credit and Collection Policy
- Income/Asset Guidelines
- Frequently Asked Questions (VT)
If you qualify for financial assistance, UVM Health cannot charge you more than the amounts generally billed to individuals with health insurance.
Home Health & Hospice
Please contact us to learn more about financial assistance programs at Home Health & Hospice.
By phone
In-person
Home Health & Hospice
1110 Prim Road
Colchester, VT 05446
Providers Offering Financial Assistance and Discounted Care
Not all providers are covered by our financial assistance policy. To find out if your provider is covered, see the participating providers list below. If your provider is not listed, they are not covered under our financial assistance policy.
Hospital Bills: All UVM Health eligible services are covered under the financial assistance policy.
Provider Bills: To determine if your provider is covered under the financial assistance policy, please see the list of providers listed below your UVM Health partner hospital.
| Provider Name | Location Name | Hospital | Accepts Financial Assistance |
|---|---|---|---|
| Yasmeen Abdul-Karim, MD | Vermont Center For Children, Youth And Families | Golisano Children's Hospital | Yes |
| Jeff Abell, PA-C | Emergency Department | Porter Medical Center | Yes |
| Jeff Abell, PA-C | ExpressCare | Porter Medical Center | Yes |
| Kevin R. Abnet, MD | Anesthesiology - Fanny Allen | University of Vermont Medical Center | Yes |
| Kevin R. Abnet, MD | Anesthesiology | University of Vermont Medical Center | Yes |
| Lauren Abramowitz, NP | Integrative Family Medicine - Montpelier | Central Vermont Medical Center | Yes |
| Amer K. Abu Alfa, MD | Laboratory Services | University of Vermont Medical Center | Yes |
| Faiz Abu-Jaber, MD | Hospital Medicine | University of Vermont Medical Center | Yes |
| Faiz Abu-Jaber, MD | PMC Coverage Group | Porter Medical Center | Yes |
| Faiz Abu-Jaber, MD | Hospital Medicine | Central Vermont Medical Center | Yes |
Financial Assistance
Health Assistance Program
Our Health Assistance Program (HAP) helps eligible low- and middle-income families get prescription medications at no cost, even if you have insurance.
Translated Documents
Arabic – العربية
Vermont
- لرعاية المجانية (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- لرعاية المجانية (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- لرعاية المجانية (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- طلب الحصول على المساعدة المالية | Application Form (Vermont)
- أسئلة وإجابات ومعلومات ينبغي أن تعرفه | Frequently Asked Questions (Vermont)
- توجيهات الدخل والأصول لعام | Income/Assets Guidelines (Vermont)
- برنامج المساعدة المالي ة (PAS1A) | Financial Assistance Policy
- تقييد الرسوم (PAS35) | Limitation on Charges Policy
- بیان الإقامة | Statement of Residency (Vermont)
- إقرار ذاتي بالدخل | Letter of Income Self-Attestation
- الديون والتحصيالت | Credit and Collection Policy
New York
- لرعاية المجانية (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- لرعاية المجانية (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- لرعاية المجانية (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- طلب الحصول على المساعدة المالية | Application Form (New York)
- برنامج المساعدة المالي ة (PAS1B) | Financial Assistance Policy
- تقييد الرسوم (PAS35) | Limitation on Charges Policy
- إقرار ذاتي بالدخل | Letter of Income Self-Attestation
- الديون والتحصيالت | Credit and Collection Policy
Bosnian – bosanski
Vermont
- Sažetak police (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- Sažetak police (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- Sažetak police (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- Prijava za finansijsku pomoć | Application Form (Vermont)
- Pitanja i odgovori i informacije koje trebate znati | Frequently Asked Questions (Vermont)
- Smjernice za prihod i imovinu za | Income/Assets Guidelines (Vermont)
- Program finansijske pomoći za pacijente (PAS1A) | Financial Assistance Policy
- Ograničenje troškova (PAS35) | Limitation on Charges Policy
- Izjava o prebivalištu | Statement of Residency (Vermont)
- Pismo samoprovjere prihoda | Letter of Income Self-Attestation
- Kreditiranje i naplata | Credit and Collection Policy
New York
- Sažetak police (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- Sažetak police (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- Sažetak police (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- Prijava za finansijsku pomoć | Application Form (New York)
- Program finansijske pomoći za pacijente (PAS1B) | Financial Assistance Policy
- Ograničenje troškova (PAS35) | Limitation on Charges Policy
- Pismo samoprovjere prihoda | Letter of Income Self-Attestation
- Kreditiranje i naplata | Credit and Collection Policy
Burmese – မြန်မာ
Vermont
- ပပေါ်လစီအနှစ်ခ ျုပ် (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- ပပေါ်လစီအနှစ်ခ ျုပ် (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- ပပေါ်လစီအနှစ်ခ ျုပ် (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- င ွေင ေးင ကေးင ေးအကူအညီဆ ု ် ော ငလ ောက် ောေးလ ော | Application Form (Vermont)
- သ ်သိထ ေးသ ်သည ် အငမေးအင ြေမ ေးနှ ် အခ က်အလက်မ | Frequently Asked Questions (Vermont)
- ခုနှစ်၊ ဝင်ငငွေနှင ် ပ ုင်ဆ ုင်မှုဆ ုင်ရာ လမ််းညွှန်ချက်မျာ် | Income/Assets Guidelines (Vermont)
- အခကြေးငွေအပေါ် ကန့်သတ်ချက် (PAS1A) | Financial Assistance Policy
- ဘဏ္ဍာရေးအကူအညီမူဝါဒ (PAS35) | Limitation on Charges Policy
- ေနထိုင်ေကာင်း ေကညာချက် | Statement of Residency (Vermont)
- ဝင်ေငွအေကာင်း ကိုယ်တိုင်ခံဝန်ချက်စာလွှာ | Letter of Income Self-Attestation
- ထ က်းမမီန င ် ထကာက်ြေုံ မှုမျာ် | Credit and Collection Policy
New York
- ပပေါ်လစီအနှစ်ခ ျုပ် (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- ပပေါ်လစီအနှစ်ခ ျုပ် (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- ပပေါ်လစီအနှစ်ခ ျုပ် (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- င ွေင ေးင ကေးင ေးအကူအညီဆ ု ် ော ငလ ောက် ောေးလ ော | Application Form (New York)
- အခကြေးငွေအပေါ် ကန့်သတ်ချက် (PAS1B) | Financial Assistance Policy
- ဘဏ္ဍာရေးအကူအညီမူဝါဒ (PAS35) | Limitation on Charges Policy
- ဝင်ေငွအေကာင်း ကိုယ်တိုင်ခံဝန်ချက်စာလွှာ | Letter of Income Self-Attestation
- ထ က်းမမီန င ် ထကာက်ြေုံ မှုမျာ် | Credit and Collection Policy
Dari – دری
Vermont
- مراقبت رایگا ن (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- مراقبت رایگا ن (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- مراقبت رایگا ن (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- درخواست کمک مالی | Application Form (Vermont)
- سوال و جواب و معلوماتی که باید بدانید | Frequently Asked Questions (Vermont)
- دستورالعمل های عاید و دارایی سال | Income/Assets Guidelines (Vermont)
- محدودیت در هزینه ها (PAS1A) | Financial Assistance Policy
- پالیسی کمک مالی (PAS35) | Limitation on Charges Policy
- بیانیھ اقامت | Declaration of Residency (Vermont)
- نامھ تصدیق خودی عاید | Letter of Income Self-Attestation
- عنوان: کریدت و وصول ها| Credit and Collection Policy
New York
- مراقبت رایگا ن (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- مراقبت رایگا ن (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- مراقبت رایگا ن (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- درخواست کمک مالی | Application Form (New York)
- محدودیت در هزینه ها (PAS1B) | Financial Assistance Policy
- پالیسی کمک مالی (PAS35) | Limitation on Charges Policy
- نامھ تصدیق خودی عاید | Letter of Income Self-Attestation
- عنوان: کریدت و وصول ها| Credit and Collection Policy
French – Français
Vermont
- Résumé de la politique (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- Résumé de la politique (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- Résumé de la politique (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- Demande d’aide financière | Application Form (Vermont)
- Questions, réponses et informations à connaître | Frequently Asked Questions (Vermont)
- Lignes directrices sur les revenus et les actifs pour | Income/Assets Guidelines (Vermont)
- Limitation des frais (PAS1A) | Financial Assistance Policy (Vermont)
- Politique d’aide financière (PAS35) | Limitation on Charges Policy (Vermont)
- Déclaration de résidence | Declaration of Residency (Vermont)
- Lettre d’attestation de revenus | Letter of Income Self-Attestation
- | Credit and Collection Policy
New York
- Résumé de la politique (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- Résumé de la politique (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- Résumé de la politique (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- Demande d’aide financière | Application Form (New York)
- Limitation des frais (PAS1B) | Financial Assistance Policy (New York)
- Politique d’aide financière (PAS35) | Limitation on Charges Policy (New York)
- Lettre d’attestation de revenus | Letter of Income Self-Attestation
Haitian Creole
Vermont
- Rezime Règleman (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- Rezime Règleman (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- Rezime Règleman (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- Pwogram Asistans Finansye | Application Form (Vermont)
- Pwogram Asistans Finansye | Frequently Asked Questions (Vermont)
- Lignes directrices sur les revenus et les actifs pour | Income/Assets Guidelines (Vermont)
- Pwogram Asistans Finansye – lopital Vermont (PAS1A) | Financial Assistance Policy (Vermont)
- Limitasyon sou Frè (PAS35) | Limitation on Charges Policy (Vermont)
- Deklarasyon Rezidans | Declaration of Residency (Vermont)
- Lèt Oto-Atestasyon Revni | Letter of Income Self-Attestation
- | Credit and Collection Policy
New York
- Rezime Règleman (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- Rezime Règleman (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- Rezime Règleman (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- Pwogram Asistans Finansye | Application Form (New York)
- Pwogram Asistans Finansye – Lopital New York (PAS1B) | Financial Assistance Policy (New York)
- Limitasyon sou Frè (PAS35) | Limitation on Charges Policy (New York)
- Lèt Oto-Atestasyon Revni | Letter of Income Self-Attestation
Kinyarwanda
Vermont
- Incamake y’amabwiriza (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- Incamake y’amabwiriza (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- Incamake y’amabwiriza (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- Porogaramu y’ubufasha bw’amafaranga | Application Form (Vermont)
- Porogaramu y’ubufasha bw’amafaranga | Frequently Asked Questions (Vermont)
- Amabwiriza ya 2025 arebana n’amafaranga yinjizwa n’umutungo | Income/Assets Guidelines (Vermont)
- Porogaramu y’ubufasha bw’amafaranga (PAS1A) | Financial Assistance Policy
- Imbogamizi ku mafaranga yishyuzwa (PAS35) | Limitation on Charges Policy
- Inyandiko y’aho utuye | Declaration of Residency (Vermont)
- Ibaruwa yo kwemeza amafaranga winjiza | Letter of Income Self-Attestation
- | Credit and Collection Policy
New York
- Incamake y’amabwiriza (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- Incamake y’amabwiriza (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- Incamake y’amabwiriza (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- Ubusabe bw’ubufasha bw’amafaranga muri NYS Uniform Hospital | Application Form (New York)
- Porogaramu y’ubufasha bw’amafaranga (PAS1B) | Financial Assistance Policy
- Imbogamizi ku mafaranga yishyuzwa(PAS35) | Limitation on Charges Policy
- Ibaruwa yo kwemeza amafaranga winjiza | Letter of Income Self-Attestation
Kirundi
Vermont
- Incamake y’Itegeko (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- Incamake y’Itegeko (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- Incamake y’Itegeko (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- Gusaba Imfashanyo y’Amahera | Application Form (Vermont)
- Ibibazo & Inyishu be n’amakuru ukwiye kumenya | Frequently Asked Questions (Vermont)
- Imirongo Ngenderwako ku Vyinjira n’Imitungo | Income/Assets Guidelines (Vermont)
- Umugambi wo gufasha mu vy’amahera (PAS1A) | Financial Assistance Policy
- Kugabanya ayishurwa (PAS35) | Limitation on Charges Policy
- Icemezo c’aho ubaye | Declaration of Residency (Vermont)
- Ikete ryerekana rikemeza ubutunzi winjiza | Letter of Income Self-Attestation
- | Credit and Collection Policy
New York
- Incamake y’Itegeko (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- Incamake y’Itegeko (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- Incamake y’Itegeko (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- Gusaba Imfashanyo y’Amahera | Application Form (New York)
- Umugambi wo gufasha mu vy’amahera (PAS1B) | Financial Assistance Policy
- Kugabanya ayishurwa (PAS35) | Limitation on Charges Policy
- Ikete ryerekana rikemeza ubutunzi winjiza | Letter of Income Self-Attestation
Lingala
Vermont
- Politiki na mokuse (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- Politiki na mokuse (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- Politiki na mokuse (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- Programe ya Lisungi ya Mbongo | Application Form (Vermont)
- Mituna & Biyano mpe Makambo oyo Osengeli Koyeba | Frequently Asked Questions (Vermont)
- Programe ya Lisungi ya Mbongo (PAS1A) | Financial Assistance Policy
- Ndelo ya ba frais (PAS35) | Limitation on Charges Policy
- Bosakoli ya Esika ya Kofanda | Statement of Residency (Vermont)
- Mokanda ya Auto-Attestation ya Salere | Letter of Income Self-Attestation
- Malako ya 2025 mpo na salere mpe biloko | Income/Assets Guidelines (Vermont)
- | Credit and Collection Policy
New York
- Politiki na mokuse (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- Politiki na mokuse (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- Politiki na mokuse (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- Bosengi ya Lisalisi ya Mbongo mpo na Lopitalo ya NYS Uniform | Application Form (New York)
- Programe ya Lisungi ya Mbongo (PAS1B) | Financial Assistance Policy
- Ndelo ya ba frais (PAS35) | Limitation on Charges Policy
- Mokanda ya Auto-Attestation ya Salere | Letter of Income Self-Attestation
Mandarin – 简体中文
Vermont
- 政策概览 (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- 政策概览 (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- 政策概览 (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- 经济援助申请表 | Application Form (Vermont)
- 常见问题解答和重要须知信息 | Frequently Asked Questions (Vermont)
- 年收入和资产指南 | Income/Assets Guidelines (Vermont)
- 财政援助计划 (PAS1A) | Financial Assistance Policy
- 收费限制 (PAS35) | Limitation on Charges Policy
- 收入自我证明 | Letter of Income Self-Attestation
- 居住声明 | Declaration of Residency (Vermont)
- | Credit and Collection Policy
New York
- 政策概览 (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- 政策概览 (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- 政策概览 (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- 经济援助申请表 | Application Form (New York)
- 财政援助计划 (PAS1B) | Financial Assistance Policy
- 收费限制 (PAS35) | Limitation on Charges Policy
- 收入自我证明 | Letter of Income Self-Attestation
Nepali - नेपाली
Vermont
- त सारांश (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- त सारांश (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- त सारांश (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- आथर्क सहायता आवेदन | Application Form (Vermont)
- तपालाई थाहा हुनुपन प्रश्नहरू र उत्तरहरू र जानकार | Frequently Asked Questions (Vermont)
- आय र सम्पित्त दशानदशहरू | Income/Assets Guidelines (Vermont)
- िवीय सहायता कायम (PAS1A) | Financial Assistance Policy
- शुल्किरूमा हसहमतता (PAS35) | Limitation on Charges Policy
- आय तः प्रमाणीकरण पत | Letter of Income Self-Attestation
- बसोबासको कथन | Declaration of Residency (Vermont)
- उिािो तिा सङ्कलनहर | Credit and Collection Policy
New York
- त सारांश (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- त सारांश (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- त सारांश (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- आथर्क सहायता आवेदन | Application Form (New York)
- िवीय सहायता कायम (PAS1B) | Financial Assistance Policy
- शुल्किरूमा हसहमतता (PAS35) | Limitation on Charges Policy
- आय तः प्रमाणीकरण पत | Letter of Income Self-Attestation
- उिािो तिा सङ्कलनहर | Credit and Collection Policy
Pashto – پښتو
Vermont
- وړیا پاملرنھ (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- وړیا پاملرنھ (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- وړیا پاملرنھ (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- د مالي مرستې غوښتنلیک | Application Form (Vermont)
- پوښتنې او ځوابونھ او ھغھ معلومات چې تاسو پرٻباید پوه شئ | Frequently Asked Questions (Vermont)
- د عاید او شتمنۍ لارښوونې | Income/Assets Guidelines (Vermont)
- د مالي مرستو پروګرام (PAS1A) | Financial Assistance Policy
- په لګښتونو محدودیت (PAS35) | Limitation on Charges Policy
- د استوګنې بیانیھ | Declaration of Residency (Vermont)
- پخپلھ د عاید لپاره د ځان د تصدیق کولو لیک | Letter of Income Self-Attestation
- کریډیټ او راټولونه | Credit and Collection Policy
New York
- وړیا پاملرنھ (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- وړیا پاملرنھ (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- وړیا پاملرنھ (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- د مالي مرستې غوښتنلیک | Application Form (New York)
- د مالي مرستو پروګرام (PAS1B) | Financial Assistance Policy
- په لګښتونو محدودیت (PAS35) | Limitation on Charges Policy
- پخپلھ د عاید لپاره د ځان د تصدیق کولو لیک | Letter of Income Self-Attestation
- کریډیټ او راټولونه | Credit and Collection Policy
Somali – Soomaali
Vermont
- Xeerka oo Kooban (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- Xeerka oo Kooban (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- Xeerka oo Kooban (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- Codsiga Kaalmada Maaliyada | Application Form (Vermont)
- Su’aalaha & Jawaabaha iyo Macluumaadka ay tahay inaad Ogaato | Frequently Asked Questions (Vermont)
- Dakhliga iyo Hagitaanada Hantida | Income/Assets Guidelines (Vermont)
- Barnaamijka Kaalmada Dhaqaalaha (PAS1A) | Financial Assistance Policy
- Xadidaada Kharashaadka (PAS35) | Limitation on Charges Policy
- Bayaan Deganaansho | Declaration of Residency (Vermont)
- Warqadda Caddeynta Dakhliga ee Is-qirashada | Letter of Income Self-Attestation
- Deynta iyo Uruurinta | Credit and Collection Policy
New York
- Xeerka oo Kooban (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- Xeerka oo Kooban (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- Xeerka oo Kooban (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- Codsiga Kaalmada Maaliyada | Application Form (New York)
- Barnaamijka Kaalmada Dhaqaalaha (PAS1B) | Financial Assistance Policy
- Xadidaada Kharashaadka (PAS35) | Limitation on Charges Policy
- Warqadda Caddeynta Dakhliga ee Is-qirashada | Letter of Income Self-Attestation
- Deynta iyo Uruurinta | Credit and Collection Policy
Spanish – Español
Vermont
- Resumen de la política (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- Resumen de la política (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- Resumen de la política (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- Solicitud de ayuda económica | Application Form (Vermont)
- Preguntas y respuestas e información que debe saber | Frequently Asked Questions (Vermont)
- Directrices de ingresos y activos | Income/Assets Guidelines (Vermont)
- Programa de asistencia financiera (PAS1A) | Financial Assistance Policy
- Limitación de cargos (PAS35) | Limitation on Charges Policy
- Declaración de residencia | Declaration of Residency (Vermont)
- Carta de autodeclaración de ingresos | Letter of Income Self-Attestation
- Crédito y cobros | Credit and Collection Policy
New York
- Resumen de la política (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- Resumen de la política (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- Resumen de la política (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- Solicitud de ayuda económica | Application Form (New York)
- Programa de asistencia financiera (PAS1B) | Financial Assistance Policy
- Limitación de cargos (PAS35) | Limitation on Charges Policy
- Carta de autodeclaración de ingresos | Letter of Income Self-Attestation
- Crédito y cobros | Credit and Collection Policy
Swahili – Kiswahili
Vermont
- Muhtasari wa Sera (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- Muhtasari wa Sera (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- Muhtasari wa Sera (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- Ombi la Usaidizi wa Kifedha | Application Form (Vermont)
- Maswali na Majibu na Taarifa Unazopaswa Kujua | Frequently Asked Questions (Vermont)
- Miongozo ya Mapato na Mali | Income/Assets Guidelines (Vermont)
- Mpango wa Usaidizi wa Kifedha (PAS1A) | Financial Assistance Policy
- Vikomo vya Ada (PAS35) | Limitation on Charges Policy
- Taarifa ya Ukaaji | Declaration of Residency (VT)
- Barua ya Uthibitishaji wa Mapato | Letter of Income Self Attestation
- Mikopo na Kukusanya Malipo | Credit and Collection Policy
New York
- Muhtasari wa Sera (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- Muhtasari wa Sera (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- Muhtasari wa Sera (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- Ombi la Usaidizi wa Kifedha | Application Form (New York)
- Mpango wa Usaidizi wa Kifedha (PAS1B) | Financial Assistance Policy
- Vikomo vya Ada (PAS35) | Limitation on Charges Policy
- Barua ya Uthibitishaji wa Mapato | Letter of Income Self Attestation
- Mikopo na Kukusanya Malipo | Credit and Collection Policy
Ukrainian – українська
Vermont
- Короткий огляд політики (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- Короткий огляд політики (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- Короткий огляд політики (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- Заява на отримання фінансової допомоги | Application Form (Vermont)
- Поширені запитання й важлива інформація | Frequently Asked Questions (Vermont)
- Вимоги до розміру доходу й активів на рік | Income/Assets Guidelines (Vermont)
- Програма фінансової підтримки (PAS1A) | Financial Assistance Policy
- Обмеження щодо витрат (PAS35) | Limitation on Charges Policy
- Заява про резиденство | Declaration of Residency (VT)
- Лист щодо самостійного підтвердження доходів | Letter of Income Self-Attestation
- | Credit and Collection Policy
New York
- Короткий огляд політики (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- Короткий огляд політики (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- Короткий огляд політики (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- Заява на отримання фінансової допомоги | Application Form (New York)
- Програма фінансової підтримки (PAS1B) | Financial Assistance Policy
- Обмеження щодо витрат (PAS35B) | Limitation on Charges Policy
- Лист щодо самостійного підтвердження доходів | Letter of Income Self-Attestation
Vietnamese – Tiếng Việt
Vermont
- Bản Tóm Lược Chính Sách (UVMMC) | Financial Assistance Policy Summary (UVM Medical Center)
- Bản Tóm Lược Chính Sách (CVMC) | Financial Assistance Policy Summary (Central Vermont Medical Center)
- Bản Tóm Lược Chính Sách (PMC) | Financial Assistance Policy Summary (Porter Medical Center)
- Đơn đăng ký nhận hỗ trợ tài chính | Application Form (Vermont)
- Hỏi ĐÁP VÀ Thông tin Cần Biết | Frequently Asked Questions (Vermont)
- Quy Định Năm Về Thu Nhập Và Tài Sản | Income/Assets Guidelines (Vermont)
- Chương Trình Hỗ Trợ Tài Chính (PAS1A) | Financial Assistance Policy
- Giới Hạn Các Khoản Phí (PAS35) | Limitation on Charges Policy
- Tuyên bố Cư trú | Declaration of Residency (Vermont)
- Thư Tự xác nhận Thu nhập | Letter of Income Self-Attestation
- | Credit and Collection Policy
New York
- Bản Tóm Lược Chính Sách (CVPH) | Financial Assistance Policy Summary (Champlain Valley Physicians Hospital)
- Bản Tóm Lược Chính Sách (AHMC) | Financial Assistance Policy Summary (Alice Hyde Medical Center)
- Bản Tóm Lược Chính Sách (ECH) | Financial Assistance Policy Summary (Elizabethtown Community Hospital)
- Đơn đăng ký nhận hỗ trợ tài chính | Application Form (New York)
- Chương Trình Hỗ Trợ Tài Chính (PAS1B) | Financial Assistance Policy
- Giới Hạn Các Khoản Phí (PAS35) | Limitation on Charges Policy
- Thư Tự xác nhận Thu nhập | Letter of Income Self-Attestation
Contact
If you want more information about the financial assistance program, need help with the application process or have questions about your application status, please contact our customer service team at 802-847-8000 or 800-639-2719 (toll-free).