Financial Assistance Policy

AtlantiCare Regional Medical Center's (ARMC) Financial Assistance Policy (FAP) exists to provide eligible patients partially or fully-discounted emergency or other medically necessary healthcare services provided by ARMC (as defined by the IRS). Patients seeking financial assistance must complete and submit an application form.

Please use the link below to download, print, and complete your application. Bring your completed application to one of our three locations during the hours designated below.

Charity Care/Financial Services

Effective January 1st, 2014 The Charity Care program is designed to help those individuals that are not eligible for the insurances offered through the Health Insurance Marketplace or have a balance after their insurance has paid.

Eligibility is based upon your income and assets on your day of service. The program does not cover physician fees. The documents listed below (with some examples) may be requested to complete your Charity Care Application:

Identification: For example, Driver’s License or Passport or Birth Certificate or Social Security Card for each member of the family.
Proof of NJ Residency (prior to date of service): NJ Driver’s License or utility bill or copy of lease or deed or support letter.
Documentation of income: Pay stubs or letter from the employer on letterhead that provides a breakdown of your gross salary either 4 weeks 13 weeks or 52 weeks prior to the date of service. Social Security benefit letter or Welfare (Package “G”) benefit letter (covering the date of service). If no income was earned then a support letter should be included with the application.
Documentation of Assets: Checking and Savings accounts, IRA’s, 401k's, Stocks, Bonds and certificate of deposits are all examples of the type of balances that are to be provided as of the date of service on your Charity Care application.

To apply for the Charity Care Program, download and complete the following form.

English

Charity Care Checklist

Charity Care Application

Espanol

Charity Care Checklist

Charity Care Application

Your completed application should be mailed or delivered to one of the following locations:

AtlantiCare HealthPlex

1401 Atlantic Avenue
Atlantic City, NJ 08401

In-Person Drop off
Monday thru Friday
7:30 AM – 4:30 PM
1st Floor – Outpatient Registration
Office #1356

AtlantiCare Regional Medical Center

65 W. Jimmie Leeds Road
Pomona, NJ 08240

In-person Drop off
Monday thru Friday
8:00 AM – 4:00 PM
Report to Hospital Lobby Information Desk for Pass

AtlantiCare Health Park at Hammonton

219 N. White Horse Pike
Hammonton, NJ 08037

In-person Drop off
Monday - Friday
11:00 AM – 7:00 PM

Discounted Charges (IRS 501r)

AtlantiCare Regional Medical Center's (ARMC) discounted charges exists to provide eligible patients partially or fully-discounted emergency or other medically necessary healthcare services provided by ARMC (as defined by the IRS). This financial assistance program is for people who DO NOT qualify for charity care. Please call 609-272-2500 to see if you qualify to have your patient liability reduced.