Medical Assistance Program

It is the policy of the Castle Rock Hospital District [CRHD] to provide essential medical services regardless of the patient’s ability to pay.  However, CRHD is the payer of last resort.  Discounts are offered to qualified patients based upon household income and size.  A sliding fee schedule is used to calculate the basic discount and is updated each year using the federal poverty guidelines.  Once approved, the discount will be honored for three months, after which the patient may reapply.

Persons will be charged for services to the extent that payment will be made by a third party authorized or under legal obligation to pay the charges.  If the patient has medical insurance, we are required to collect the deductible and/or co-pay due.  We will accept assignment under the Social Security Act for all services for which payment may be made under Part B of Title XVIII (‘Medicare”) of the Act.

The Billing Specialist, upon request, will distribute to potential recipients the information they will need in order to complete the application for the Medical Assistance Program.  Once the information has been completed it will be turned over to the CFO who will determine, following the guidelines listed below, whether the applicant qualifies for medical assistance.  This information will be given to the Board of Trustees as the discounts are used.

Patients that are not eligible for the Medical Assistance Program and do not have insurance coverage, can receive 20% off of non-discounted services if paid within 30 days of date of service. For more information, call 307-872-4500 ext. 4.

Guidelines

1. 1. The Sliding Fee Scale may be used for all services provided by Castle Rock Hospital District. Reference laboratory tests and consulting radiology interpretations are excluded.  The funds may be applied to the remaining balances of accounts from prior visits as well as to current accounts.
   2. The Sliding Fee Scale will be applied to the accounts of all qualifying applicants for a three (3) month period.  Applicant may reapply after the third month.
   3. Eligibility for Medical Assistance will be limited to persons whose family unit income is not more than the income guidelines established by the Castle Rock Hospital District Board of Trustees as listed below using the HHS Poverty Level Guidelines.
   4. Persons whose family unit income exceeds these income guidelines are not eligible for assistance under this program.
   5. Persons whose family unit income is less than the Wyoming Medicaid income guidelines are not eligible for assistance under this program, as they are eligible for Wyoming Medicaid.  Visit Wyoming Medicaid for more information.
   6. Applicants will receive a written determination of eligibility
   7. Any questions regarding the Sliding Fee Scale may be directed to the District’s Billing Office.

*A “Family Unit” shall be defined as “any blood relatives living in the same household, any married couple living in the same household, or any non-related individuals living in the same household as a family unit.”

*An “Economic Family Unit” shall be defined as all individuals living in the same household that have a legal financial responsibility with the guarantor of the account(s).  An adjustment to the Economic Family Unit income will be made by increasing the total monthly income by the In-kind Support Maintenance Figure as determined by the federal government for each individual.  The income adjustment will be made to account for shared living expenses.  The income guidelines for an Economic Family Unit are the same as for a Family Unit.

*Examples of income include:  pay from employment, interest, dividends, unemployment benefits, child support, alimony, Social Security benefits, Veteran’s Administration benefits, benefits from all state and federal programs, and taxable tips.

Information Needed

• A completed copy of your most recent income tax return with the associated W-2 forms.
• Copies of your most recent payroll information with YTD totals from all employers for the current year, or a written statement from your employers indicating your gross YTD earnings.
• Printouts from all agencies that you have received benefits from over the last twelve months.  Examples include:  food stamps, unemployment, AFDC, Worker’s Compensation, Social Security, financial aid information pertaining to secondary schooling, etc.
• A printout from the Clerk of Court indicating the monthly child support that you receive.
• Letters from friends or family members who assist you with your financial needs, explaining the assistance they provide for you.
• Copies of your most recent investment and bank statements.
• Copy of denial letter received from Medicaid.