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Financial Counseling
Pleasant Valley Hospital is dedicated to providing quality healthcare to all patients regardless of age, sex, sexual orientation, race, religion, disability, veteran, national origin, and/or ability to pay.
In emergencies, treatment will not be delayed because of financial or insurance issues. Pleasant Valley Hospital prohibits any actions that would discourage individuals from seeking emergency medical care, such as demanding that emergency department patients’ pay before receiving treatment for emergency medical conditions or by permitting debt collection activities that interfere with the provision, without discrimination, of emergency medical care.
Who is Eligible for Financial Assistance?
Any patients receiving or seeking to receive emergency or other medically necessary care at Pleasant Valley Hospital are eligible for financial assistance:
- Has a household income equal to or less than 200% of the Federal Poverty Guidelines
- Individual is denied Medicaid Coverage
- Applied within 240 days from initial patient statement date
Sample of Income Guidelines for 2023:
For families/households with more than 8 persons, add $5,140 for each additional person.
| Family Size | FPG | <200% |
|---|---|---|
| 1 | $14,580 | $29,160 |
| 2 | $19,720 | $39,440 |
| 3 | $24,860 | $49,720 |
| 4 | $30,000 | $60,000 |
| 5 | $35,140 | $70,280 |
| 6 | $40,280 | $80,560 |
| 7 | $45,420 | $90,480 |
| 8 | $50,560 | $101,120 |
How Do I Apply for Financial Assistance?
- Prior to receiving services, an individual may contact Patient Financial Services at 304.675.1020 or the Financial Counselor at 304.675.4340 ext. 1394.
- By visiting the Financial Counselor’s Office between 7:30 a.m. and 4:00 p.m. on Monday through Friday.
- Financial Counselor will assist with applying Medicaid application.
- Individual may download application below and return by mail to the address on the application, 2520 Valley Drive, Point Pleasant, WV, 25550.
Please complete all sections of the application form and assemble all required documentation prior to submitting your application. If you need help completing your application, contact our Financial Counselor directly at 304.675.4340 ext. 1394 or in the office at 2520 Valley Drive, Point Pleasant, WV, 25550 between 7:30 a.m. and 4:00 p.m. on Monday through Friday.
Completed applications can be mailed to Pleasant Valley Hospital, 2520 Valley Drive, Point Pleasant, WV, 25550.
Financial Assistance Application Plain Summary Language Financial Assistance Policy