FinancialAssistance

Financial Assistance/Charity Care

(757) 668-7141

Children’s Hospital of The King’s Daughters is committed to caring for all patients, birth to age 21, without regard to their financial situation.

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Do You Qualify?

CHKD cares for every child who needs our services, regardless of any family’s ability to pay.  Depending on your income and family size, you may qualify for our financial assistance.

For more information about the program, please call (757) 668-7141 to speak confidentially to the health benefits analyst.

Applicants will be asked to provide documented proof of need including income tax records, pay stubs, family size and proof of residence.

To apply, fill out this typeable PDF. Be sure to sign and date your application, then submit the completed application via mail, fax or email.

Children’s Hospital of The King’s Daughters Patient Financial Services – HBA
601 Children’s Lane
Norfolk, VA 23507
Phone: (757) 668-7141
Email: charitycare@chkd.org
Fax (757) 668-9181 

Our health benefits analysts will let you know if discounted or free care is an option, based on the federal poverty guidelines for income and family size as illustrated in the chart below. 

CHKD’s Guidelines for Financial Assistance*

Number of Adults and Children in Family

Percent Reduction of CHKD Charges Based on Income
 100%75%50%25%
       1Income up to $21,244 Income up to $30,349 Income up to $39,454 Income up to $48,560
       2Income up to $28,804Income up to $41,149Income up to $53,494Income up to $65,840
       3Income up to $36,364Income up to $51,949Income up to $67,534Income up to $83,120
       4Income up to $43,924Income up to $62,749Income up to $81,574Income up to $100,400
       5Income up to $51,484Income up to $73,449Income up to $95,614 Income up to $117,680
       6Income up to $59,044Income up to $84,349Income up to $109,654 Income up to $134,960
       7Income up to $66,604Income up to $95,149Income up to $123,694 Income up to $152,240
       8Income up to $74,164Income up to $105,949Income up to $137,734 Income up to $169,520

 *Chart uses 2018 federal poverty guidelines. For future poverty guidelines, visit http://aspe.hhs.gov/poverty/.

Assets include, but are not limited to, primary residence, rental property, securities, bank deposits, business assets and investments.

¿Usted califica?

El Children’s Hospital of The King’s Daughters se preocupa por cada niño que necesita nuestros servicios, independientemente de la capacidad de cualquier familia que pagar. Dependiendo del tamaño de los ingresos y de la familia, usted puede calificar para nuestra ayuda financiera.

Para obtener más información sobre el programa, por favor llame al (757) 668-7141 para hablar confidencialmente con el analista de beneficios para la salud.

Se les pedirá a los solicitantes que presenten una prueba documentada de necesidad incluyendo los registros de impuestos, recibos de pago , tamaño de la familia y prueba de residencia.

Para solicitar, llene este tipificable PDF. Asegúrese de firmar y fechar su solicitud , a continuación, enviar la solicitud completa por correo, fax o correo electrónico.

Children’s Hospital of The King’s Daughters Patient Financial Services – HBA
601 Children’s Lane 
Norfolk , VA 23507
Teléfono: 757.668.7141
E-mail: charitycare@chkd.org
FAX : 757.668.9181

Instrucciones para Asistencia Financiera en el CHKD 

Número de Adultos y Niños en la Familia Porcentage de Reducción de Cargos del CHKD Basado en Ingresos
 100%75%50%25%
       1Ingreso hasta $21,244Ingreso hasta $30,349Ingreso hasta $39,454Ingreso hasta $48,560
       2Ingreso hasta $28,804Ingreso hasta $41,149Ingreso hasta $53,494Ingreso hasta $65,840
       3Ingreso hasta  36,364Ingreso hasta  $51,949Ingreso hasta  $67,534Ingreso hasta  $83,120
       4Ingreso hasta  $43,924Ingreso hasta  $62,749Ingreso hasta  $81,574Ingreso hasta  $100,400
       5Ingreso hasta  $51,484Ingreso hasta  $73,449Ingreso hasta  $95,614 Ingreso hasta  $117,680
       6Ingreso hasta  $59,044Ingreso hasta  $84,349Ingreso hasta  $109,654 Ingreso hasta $134,960
       7Ingreso hasta  $66,604Ingreso hasta  $95,149Ingreso hasta  $123,694 Ingreso hasta  $152,240
       8Ingreso hasta  $74,164Ingreso hasta  $105,949Ingreso hasta  $137,734 Ingreso hasta  $169,520

*La tabla utiliza las recomendaciones de pobreza federal del 2018. 

 Para recomendaciones futuras, visite  http://aspe.hhs.gov/poverty/.

Los bienes/activos incluyen, pero no se limitan a, la residencia primaria, propiedades de renta, seguridades, depósitos bancarios, bienes de negocios e inversiones.

(757) 668-7141