Financial Assistance Program
The Financial Assistance Program provides direct financial assistance to Kentucky and Southern Indiana families. The program is designed to help with medical, equipment, dental, and therapy bills of children 17 years of age and under or still attending a high school whose families cannot otherwise afford to pay. Each application receives a full review to determine how best Kosair for Kids can aid the family.
To be considered for the Kosair for Kids® Financial Assistance Program
Please submit the following:
- An online application (if applying for more than one child, each child needs a separate application).
- Bill(s) or quote(s) for which you are seeking assistance. If possible, we ask that you apply for assistance before a product or service is rendered. We are unable to review the following:
- quote(s) older than 90 days
- bill(s) already in collections
- bill(s) that the insurance provider has not processed.
- Explanation of Benefits (EOB) from your insurance provider pertaining to your request.
- An EOB is a document you receive from your insurance plan after a provider has filed a claim. EOBs outline what your plan covers and what you owe for a service. An EOB is not a bill but rather an explanation of services provided and how the cost is split between you and your insurer. Typically, you will receive an EOB shortly after visiting a provider or making a purchase - such as a piece of medical equipment.
- Letter of recommendation for all non-emergency requests. The letter of recommendation will need to come from your child’s healthcare professional. This letter should include the following information:
- child's name
- child's date of birth
- diagnosis
- description of the service requested.
- the medical necessity
- cost (if known)
- duration (if applicable)
- Most recent pay stub from all working parent(s) or guardian(s)
- Most recent tax return(s). This includes any additional schedules for rental property, business income, or itemized deductions. If you have not filed taxes, we require the previous year's tax return & your current W2(s) or 1099(s).
- If parent(s) or guardian(s) file separately, we require both tax returns. Please upload the additional tax return under “Space for additional documents.”
- IF POSSIBLE, PLEASE REMOVE ALL SSN(S) FROM THE TAX RETURN(S)
ADDITIONAL INFORMATION
If the provider you are requesting assistance from offers a Financial Assistance Program, it is required for you to apply with that provider first. If you are denied assistance, please upload a copy of the denial letter with the EOB.
You will receive a confirmation email once your application has been successfully submitted. If you have questions, please contact the Kosair Kids Coordinator at 502-814-9872.