Financial Assistance at Horn Memorial Hospital

Horn Memorial Hospital provides quality medical care 24 hours a day, seven days a week, in response to the diverse medical needs of the communities we serve. We are committed to ensuring that all patients receive the care they need—regardless of their financial circumstances.

No one will be denied access to services due to their inability to pay.

A discounted/sliding fee schedule is available based on family size and income. Our staff will work with you confidentially and respectfully to help you obtain financial assistance or arrange a convenient payment plan.

How to Apply

To be considered for financial assistance, please provide the following documents:

Signed and completed Financial Assistance Application
Copy of your current Federal Tax Return
Copies of your last 3 pay stubs or Social Security income statements

Please ensure all information is accurate and complete to avoid delays in processing.

Downloadable Forms

Financial Assistance Plain Language Summary
Financial Assistance Application
Authorization to Release Information

Need Help?

If you have questions or need help completing your application, our team is here to support you.

Contact our Financial Counselor
Phone: 712-364-7219
Hours: Monday–Friday, during regular business hours