Financial Assistance

We’re Here to Help

Thank you for choosing Alice Peck Day Memorial Hospital. Our mission is to serve you and the community with the best possible health care. Hospital charges and insurance statements can be hard to understand. We want to help you be ready for your visit in all ways, including the financial aspects.

If you’re not sure how you’re going to pay your bill, we will provide you with information and contacts for a number of programs that may help you. Our staff will help you with the application process when we can. To get an application, visit the Patient Access Department at APD, call (603) 443-9579 to ask for the forms to be mailed to you, or download the Financial Aid Cover Letter and Financial Assistance Application Form.

APD Financial Assistance Programs

This program helps insured and uninsured patients whose household incomes are at or below 225% of the Federal Poverty Guidelines with 100% APD financial assistance.  Please see our Financial Assistance Policy brochure.  There is a sliding scale for those who qualify for up to 300% of Federal Poverty Guidelines. To receive an application, visit Shaunna Hafford in the Multi-Specialty Clinic or call (603) 443-9579. APD financial assistance guidelines are updated each year to reflect changes in the Federal Poverty Guidelines.

APD Discount and Payment Plan Programs

Our payment plans help patients who realize they cannot pay before their treatment or after receiving their first statement. The payment calendar will be based on the amount of money that is due. We may ask for a “good faith” payment on arrangements that will last more than six months. If you are unable to make full payment, please call the telephone number on your patient statement. APD offers uninsured patients an automatic 64.8% discount which will be reflected on your first patient statement, effective for services after May 11, 2019.

Price Estimates for Services at APD

You may ask for a price estimate at any time for all services provided at APD. 

  • The estimate can help you in planning payment arrangements.
  • You may be billed separately for professional services provided by physicians, nurse practitioners, midwives, radiologists or anesthesia professionals not employed by APD. These charges will not be included in estimates provided by the hospital, so you should also ask these providers for their estimates if you need them. The Patient Access team can help you if you aren’t sure which providers you need to get an estimate for.
     

Contacts for Obtaining Medical Insurance/Prescription Assistance

Medicaid of New Hampshire and Vermont

Medicaid is a federal and state-funded program that serves needy individuals and families who meet financial and other eligibility requirements, or individuals who lack adequate resources to pay for medical care. To learn more about the options through Medicaid, please contact APD's financial counselor at (603) 443-9579.

Medicare

Medicare is a health insurance program for people age 65 or older, some disabled people under age 65, and people of all ages with end-stage renal disease. To learn more go to www.medicare.gov/MedicareEligibility, call or visit your local Social Security office, or call (603) 443-9579.

This information will be updated regularly. Most recent revision: May 9, 2019.