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. 
Español

 

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 $21,104 Income up to $30,149 Income up to $39,194 Income up to $48,240
       2Income up to $28,419Income up to $40,599Income up to $52,779Income up to $64,960
       3Income up to $35,734Income up to $51,049Income up to $66,364Income up to $81,680
       4Income up to $43,049Income up to $61,499Income up to $79,949Income up to $98,400
       5Income up to $50,364Income up to $70,949Income up to $93,534 Income up to $115,120
       6Income up to $57,679Income up to $82,399Income up to $107,119 Income up to $131,840
       7Income up to $64,994Income up to $92,849Income up to $120,704 Income up to $148,560
       8Income up to $72,309Income up to $103,299Income up to $134,289 Income up to $165,280

 *Chart uses 2017 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 $21,104 Ingreso hasta $30,149 Ingreso hasta $39,194Ingreso hasta $48,240
       2Ingreso hasta $28,419Ingreso hasta $40,599Ingreso hasta $52,779Ingreso hasta $64,960
       3Ingreso hasta  35,734Ingreso hasta  $51,049Ingreso hasta  $66,364Ingreso hasta  $81,680
       4Ingreso hasta  $43,049Ingreso hasta  $61,499Ingreso hasta  $79,949Ingreso hasta  $98,400
       5Ingreso hasta  $50,364Ingreso hasta  $70,949Ingreso hasta  $93,534 Ingreso hasta  $115,120
       6Ingreso hasta  $57,679Ingreso hasta  $82,399Ingreso hasta  $107,119 Ingreso hasta $131,840
       7Ingreso hasta  $64,994Ingreso hasta  $92,849Ingreso hasta  $120,704 Ingreso hasta  $148,560
       8Ingreso hasta  $72,309Ingreso hasta  $103,299Ingreso hasta  $134,289 Ingreso hasta  $165,280

*La tabla utiliza las recomendaciones de pobreza federal del 2017. 

 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

Search Options Find a Doctor

or
or
or
or