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Financial Assistance

Southwest Health System, Inc. (SHS) is committed to providing financial assistance to persons who have healthcare needs and are uninsured, underinsured, medically indigent or otherwise unable to pay for emergent or medically necessary care based on their individual financial situation. Consistent with its mission to provide the highest quality healthcare to our community by bringing excellence and service together to promote, improve and restore health, SHS strives to ensure that the financial circumstances of people who need healthcare services does not prevent them from seeking or receiving care. All individuals who come to SHS’s Emergency Department, or an SHS property, for an examination or treatment for a medical condition will be screened to determine whether an emergency medical condition exists consistent with the SHS Description of Services Policy. Neither the initial medical screening nor life-saving treatment will be impeded by inquiries about the individual’s method of payment or insurance status.

We are here to help you with financial assistance so you can focus on your health and healing. Our dedicated financial assistance coordinators can help you navigate different programs that may be available to you and your family. We want to work with you to find the best program so bills are your last worry.

What are the different types of financial assistance?


Health First Colorado (Colorado’s Medicaid program) has free or low-cost health care for Colorado children and adults who qualify. People who meet specific monthly income requirements can get insurance through Health First Colorado. If you qualify, you can sign up for Health First Colorado any time during the year. You can view the current Monthly Maximum Income Guidelines at



Child Health Plan Plus (CHP+) is public low-cost health insurance for certain children and pregnant women. It is for people who earn too much to qualify for Health First Colorado (Colorado’s Medicaid program), but not enough to pay for private health insurance. You can view the current Monthly Maximum Income Guidelines at



The Colorado Indigent Care Program (CICP), provides discounted health care services to low-income people and families who reside in Colorado. CICP is not a health insurance program. CICP is for people who are not eligible for Health First Colorado (Colorado’s Medicaid program) or Child Health Plan Plus (CHP+). People who are covered by Medicare or who have other health insurance may be eligible for CICP. Discounted healthcare services are provided only by Colorado hospitals and clinics that participate in the CICP. SHS is a participating provider in the CICP. You can view the Annual Income Ranges at



Colorado Hospital Discounted Care (HDC) was created by​ ​​House Bill (HB) 21-1198. Patients who are at or below 250% of the Federal Poverty Guidelines (FPG) are eligible for Hospital Discounted Care. It limits the amount that low-income patients can be billed for health care services at hospitals and emergency rooms. It also limits amounts billed from providers who work at hospitals and emergency rooms. Hospitals must give patients the chance to apply for discounted care when they have services at the hospital. If a patient qualifies, their billed amounts will be limited to the rates set by the Department of Health Care Policy and Financing (Department). Payment plans for patients who qualify cannot be more than four 4% of the patient’s gross monthly household income for bills from the hospital. Payment plans for each provider that bills separately from the hospital cannot be more than two 2% of the patient’s gross monthly household income. Payment plans cannot be longer than 36 months of payments. Once 36 payments have been made, the bill is considered paid in full. You can view the Annual Income Ranges at


Patient’s Rights Form in English

Patient’s Rights Form in Spanish

Uniform Application (please make an appointment to complete the application with one of our financial coordinators)


As part of the Affordable Care Act (ACA), SHS has an internal Financial Assistance Policy. The Financial Assistance Program (FAP), sometimes called “charity care”, provides discounted care to people who need help paying their medical bills which may not be covered by other third-party payers or programs.

Eligibility for financial assistance under this Policy is based on income level and household size. Patients who are self-pay, or who have an outstanding bill after all insurance payments have been received, may qualify for FAP. Following are the Annual Income Ranges for FAP:



Household Size 0%-250%
1 $37,650
2 $51,100
3 $64,550
4 $78,000
5 $91,450
6 $104,900
7 $118,350
8 $131,800
For families/households with more than 8 per add $5,380 for each additional person
*Updated with the Department of Health and Human Services guidelines. Normally posted in late January every year.


Patients who qualify for assistance are eligible for up to a 100% discount for emergency and medically necessary care. Below is the current FAP copay table:


% FPL 0%-250%
SMG Clinic Services Patient Copay $0.00
SHS Hospital Services Patient Copay $0.00
SHS Retail Pharmacy Copay

340B drugs = $0.00

Non-340B drugs = $5.00


A patient who qualifies for assistance under SHS’s Financial Assistance Policy will not be charged more than the amounts generally billed to patients with emergency insurance and medically necessary care.


Download the Financial Assistance Policy-Procedure

Download Financial Assistance Policy Amounts Generally Billed

Download FAP Covered and Non-Covered Providers

Download the Financial Assistance Application

Download the Financial Assistance Amounts Generally Billed

Descargue la Política Española de Asistencia Financiera (Policy) – Coming Soon

Descargue la Hoja de Trabajo de Ayuda Financiera Española (Application) – Coming Soon


You can contact us with questions or to make an appointment with one of our knowledgeable financial assistance coordinators at:

Southwest Memorial Hospital

1311 N Mildred Road

Cortez, CO 81321

P: 970-564-2131


southwest health system

(970) 565-6666

Home Office

1311 North Mildred Road

Cortez, CO 81321



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