FinancialAssistance

Financial Assistance

(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 $20,789 Income up to $29,699 Income up to $38,609 Income up to $47,520
       2Income up to $28,034Income up to $40,049Income up to $52,064Income up to $64,080
       3Income up to $35,279Income up to $50,399Income up to $65,519Income up to $80,640
       4Income up to $42,524Income up to $60,749Income up to $78,974Income up to $97,200
       5Income up to $49,769Income up to $71,099Income up to $92,429 Income up to $113,760
       6Income up to $57,014Income up to $81,449Income up to $105,884 Income up to $130,320
       7Income up to $64,277Income up to $91,824Income up to $119,372 Income up to $146,920
       8Income up to $71,557Income up to $102,224Income up to $132,892 Income up to $163,560

 *Chart uses 2015 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 $20,789 Ingreso hasta $29,699 Ingreso hasta $38,609Ingreso hasta $47,520
       2Ingreso hasta $28,034Ingreso hasta $40,049Ingreso hasta $52,064Ingreso hasta $64,080
       3Ingreso hasta  35,279Ingreso hasta  $50,399Ingreso hasta  $65,519Ingreso hasta  $80,640
       4Ingreso hasta  $42,524Ingreso hasta  $60,749Ingreso hasta  $78,974Ingreso hasta  $97,200
       5Ingreso hasta  $49,769Ingreso hasta  $71,099Ingreso hasta  $92,429 Ingreso hasta  $113,760
       6Ingreso hasta  $57,014Ingreso hasta  $81,449Ingreso hasta  $105,884 Ingreso hasta $130,320
       7Ingreso hasta  $64,277Ingreso hasta  $91,824Ingreso hasta  $119,372 Ingreso hasta  $146,920
       8Ingreso hasta  $71,557Ingreso hasta  $102,224Ingreso hasta  $132,892 Ingreso hasta  $163,560

*La tabla utiliza las recomendaciones de pobreza federal del 2015. 

 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

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