We know that health care costs come up unexpectedly and, whether you are insured or not, it's a difficult issue. We understand, and are happy to work with any patient to resolve an unpaid balance. Click here to learn more about insurance & billing.
Our Patient Financial Services representatives are available to answer any questions you may have about your hospital bill. Representatives may be reached: Mon–Fri 8 AM–4 PM 603.663.6922
Hospitals in New Hampshire work hard to make quality health care available, affordable and accessible to all, regardless of the patient’s ability to pay. CMC participates in the following statewide programs:
Catholic Medical Center has its own financial assistance program that is available to patients who receive medically necessary care and don’t qualify for the above-mentioned statewide assistance programs.
Criteria & Application
Patients must complete a formal financial assistance application for charitable care within 240 days of receiving medically necessary services from the hospital, and only after all insurance benefits, and/or financial aid from third party payers, state and federal assistance programs, charitable or endowment funds have been exhausted. Charitable care will be available only for medical services that are reasonable and necessary for the diagnosis and treatment of illness or injury. Individuals who receive or want a cosmetic procedure are not eligible for financial assistance.
Criteria Categories for Financial Assistance
- Family income, in relation to the established federal poverty guidelines
- Assets (i.e., home, bank accounts and stocks)
- Receipt of documents stating medically necessary care is required
- Other or additional hardship (explanation required)
Financial Assistance Forms
Use the link below to access the PDF fillable application—open the file, right click to "Save As", save locally, then open that file to type in the form.
Financial Assistance Application (English)
Financial Assistance Application (Nepali)
Financial Assistance Application (Spanish)
Financial Assistance Policy (English)
Financial Assistance Policy (Nepali)
Financial Assistance Policy (Spanish)
Free Care Guildlines
The amount of financial assistance you may receive is based upon your family size and income compared to the federal poverty guidelines, also known as FPL. Please see the chart for additional information:
Financial Assistance Summary (Plain Language)
Listing of CMC Services (English)
Listing of CMC Services (Nepali)
Listing of CMC Services (Spanish)
If you feel you may qualify, please call the Patient Financial Services team at 603.663.6922
. A financial advisor will assist you with the application for charitable care and investigate other sources that might provide financial assistance for the medical care you need.