Financial Assistance Policy

MercyOne 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, MercyOne 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.

MercyOne Centerville is certified by the National Health Service Corp. This is a program that provides loan forgiveness for providers. We recently were surveyed, and they identified a required statement that needs to be on our website, in reference to financial assistance:

"No one will be denied access to services due to inability to pay. There is a discounted/sliding fee schedule available based on family size and income."

The Program


The MercyOne 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 400 percent of the Federal Poverty Level.

To qualify for any assistance, uninsured/underinsured patients will be asked to complete a MercyOne 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.

To view a list of providers that are included and/or excluded from the Financial Assistance Policy, View Provider List.

If you have questions regarding qualifying or applying for financial assistance, please contact a financial assistant representative at 641-437-3559.

To view/print a policy or form, simply click on the below link.

Financial Assistance Application


Financial Assistance Policy


Financial Assistance Plain Language Summary

Amount Generally Billed

If you qualify for partial support from MercyOne, learn the amounts generally billed/reimbursed for services at MercyOne Health hospitals.