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Financial Assistance for Patients

Catholic Health Initiatives (CHI) understands that paying for emergency and/or medically necessary medical care can be difficult, particularly for patients who lack health insurance. As part of our ongoing commitment to our patients, CHI works hard to help our patients address their financial responsibilities in a way that is fair and sensitive to their circumstances. We have instituted a program designed specifically to help those who find themselves in financial distress.

The Program

The CHI Financial Assistance Policy (available in multiple languages) applies to uninsured/underinsured patients who come to our facilities for treatment. This policy provides financial relief to patients who qualify based on a comparison of their financial resources and/or income to Federal Poverty Guidelines. The program is designed specifically for non-elective care patients whose household financial resources and/or income are at or below 300 percent of the Federal Poverty Level. 

To qualify for any assistance, uninsured/underinsured patients will be asked to complete a CHI Financial Assistance Application (available in multiple languages) which includes information relating to household income. 

We are committed to working with our patients to establish an appropriate payment plan based on the amount due and the patient’s financial status.

Financial Assistance Forms and Policies

CHI St. Joseph Health Hospitals (Regional Hospital, Burleson Hospital, Grimes Hospital, Madison Hospital)

Financial Assistance Policy and Procedure

Collections Policy and Procedure

Financial Assistance Summary - Plain Language Summary

Financial Assistance Application 


If you have any questions regarding our policies or regarding qualifying or applying for financial assistance, please call 979.776.4930, Monday – Friday, 8:00 a.m. - 5:00 p.m. 
EES Number: 979-776-4952

Physician Listings

Provider Listings


Financial Assistance Form (PDF)

Formulario de Solicitud de Asistencia (PDF)