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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 for financial assistance, please follow the steps below:

  • Download the financial assistance application and save it to your desktop.
  • Open the application from your desktop using Adobe Reader.
  • Fill out the application, add your electronic signature, and date the file.
  • Submit the completed application with the date and your electronic signature via mail, email, or fax. 

Our Mailing Address:
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 $26,355 Income up to $37,650 Income up to $48,945 Income up to $60,240
       2Income up to $35,770Income up to $51,100Income up to $66,430Income up to $81,760
       3Income up to $45,185Income up to $64,550Income up to $83,915Income up to $103,280
       4Income up to $54,600Income up to $78,000Income up to $101,400Income up to $124,800
       5Income up to $64,015Income up to $91,450Income up to $118,885 Income up to $146,320
       6Income up to $73,430Income up to $104,900Income up to $136,370 Income up to $167,840
       7Income up to $82,845Income up to $118,350Income up to $153,855 Income up to $189,360
       8Income up to $92,260Income up to $131,800Income up to $171,340 Income up to $210,880

 *Chart uses 2024 federal poverty guidelines. For current and prior 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 $26,355Ingreso hasta $37,650Ingreso hasta $48,945Ingreso hasta $60,240
       2Ingreso hasta $35,770Ingreso hasta $51,100Ingreso hasta $66,430Ingreso hasta $81,760
       3Ingreso hasta  $45,185Ingreso hasta  $64,550Ingreso hasta  $83,915Ingreso hasta  $103,280
       4Ingreso hasta  $54,600Ingreso hasta $78,000Ingreso hasta  $101,400Ingreso hasta  $124,800
       5Ingreso hasta  $64,015Ingreso hasta $91,450Ingreso hasta  $118,885Ingreso hasta  $146,320
       6Ingreso hasta  $73,430Ingreso hasta $104,900Ingreso hasta $136,370 Ingreso hasta $167,840
       7Ingreso hasta  $82,845Ingreso hasta $118,350Ingreso hasta  $153,855Ingreso hasta  $189,360
       8Ingreso hasta  $92,260Ingreso hasta  $131,800Ingreso hasta  $171,340Ingreso hasta  $210,880

*La tabla utiliza las recomendaciones de pobreza federal del 2024. 

 Para las directrices de probeza actuals y anteriores, 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.