Free Care Program

Sebasticook Valley Health (SVH) is committed to treating all patients who need our care regardless of their health insurance or financial status. If you need us, we will be there.

In addition, we offer services to help you arrange for payment of your bill, such as insurance billing, payment plans, and financial assistance, which may qualify you for reduced payment.

SVH continues to show its commitment to the local community by making free care available to applicants with a household income that is up to 250% of Federal Poverty Guidelines (FPG)*:

Size of Family Unit FPG 100% FPG 150% FPG 250%*

Size of Family Unit	FPG 100%	FPG 150%	FPG 250%*
1 2	$11,770 $15,930	$17,655 $23,895	$29,425 $39,825
3 4	$20,090 $24,250	$30,135 $36,375	$50,225 $60,625
5 6	$28,410 $32,570	$42,615 $48,855	$71,025 $81,425
7 8	$36,730 $40,890	$55,095 $61,335	$91,825 $102,225

Each additional**.......$4,160

* Families under 150% may receive 100% discount; families between 151-250% may receive 50% discount on balance
** For family units with more than 8 members

Services that are not medically necessary are not eligible for free care or financial assistance. Free care is only considered after all third party payment sources have been exhausted.

If you do not qualify for Free Care, you are entitled to ask for a fair hearing. We will tell you how to apply for a fair hearing.

SVH Patient Accounts is committed to assisting you with your billing needs. Please contact SVH Patient Accounts at 207-487-4020 (email: [email protected]) or toll-free 800-557-8578 for more details. You may also contact us via secure email by clicking here.

Below are the documents you will need to qualify and apply. You will need the Adobe Acrobat Reader to view these documents.

• Click here to download the Free Care application
• Click here to download the Free Care instruction