Cleveland Clinic’s Financial Assistance Policy is one of the most comprehensive in the country β covering uninsured patients, certain insured patients, Ohio residents under HCAP, and people facing catastrophic or exceptional circumstances even when their income exceeds the standard thresholds. Most patients who could benefit never apply because they don’t know what the program actually covers.
Cleveland Clinic’s financial assistance policy is more nuanced than a simple income cutoff β there are multiple pathways to eligibility, and several of them apply to people who earn far more than the standard threshold. These are the questions that matter most when a bill lands and you don’t know what to do next.
1 I have insurance. Can I still get financial assistance at Cleveland Clinic? Sometimes β but the rules are stricter. Insured patients are eligible only if Cleveland Clinic is in-network, and only if your insurance doesn’t cover the service, you’ve exhausted your lifetime maximum, or there are exceptional circumstances. The HCAP program in Ohio does cover insured patients at low income levels. βΌ
2 My income is above the 400% FPL limit β is there any path to help? Yes β two specific pathways exist for people over the income limit. The “Catastrophic Balance” rule applies if one episode of care exceeds 25% of your annual family income. The “Exceptional Circumstances” route applies to extreme personal or financial hardship, including terminal illness. βΌ
3 Can I still apply if my bill has already been sent to collections? Yes β the window is 240 days from your first billing statement, or, if longer, from the date a collection agency returns your account to Cleveland Clinic. Applying while in collections pauses extraordinary collection actions. βΌ
4 Will I be charged more than insured patients if I don’t qualify for full assistance? No β by law and by Cleveland Clinic’s own policy, no patient who is eligible for any financial assistance will be charged more than the Amounts Generally Billed (AGB) to patients with Medicare coverage. You can always request the AGB rate even without full assistance. βΌ
5 Does financial assistance cover my prescriptions at Cleveland Clinic? No β the financial assistance policy explicitly does not cover prescription costs. However, Cleveland Clinic will refer you to pharmaceutical company patient assistance programs. Call 866-650-6337 for prescription cost assistance referrals. A social worker can also help at 216-444-6554. βΌ
6 I’m pregnant and my insurance doesn’t cover maternity care. Does Cleveland Clinic help? Yes β maternity care is specifically called out in Cleveland Clinic’s policy. If you’re pregnant and your insurance doesn’t provide maternity benefits, you’re eligible for financial assistance as long as you meet the income criteria and are an Ohio resident (or certain Florida county residents), and agree to cooperate with determining eligibility for government maternity programs. βΌ
7 What happens if Cleveland Clinic calls me and I don’t recognize the number β should I answer? Yes β answer it. Cleveland Clinic partners with ElevatePFS and Firstsource for Medicaid screening. Ignoring their calls is treated as non-cooperation, which makes you ineligible for financial assistance and results in a bill for full services. These calls are mandatory under the policy. βΌ
Most people looking for help know about the income-based pathway. What they don’t know is that Cleveland Clinic’s policy has five additional routes to assistance β and some of them have no income ceiling at all.
Uninsured patients at Ohio Cleveland Clinic facilities whose annual family income does not exceed 400% of the Federal Poverty Guidelines are eligible for some level of assistance, from full charity care at the lowest income levels to sliding-scale discounts higher up. Ohio residency is required for HCAP services; financial assistance at higher income tiers is open to residents of all states. For Florida patients, the Weston hospital location uses the same 400% FPL threshold for uninsured patients. Income is calculated as gross annual family income β wages, salaries, Social Security, SSI, SSDI, pension, interest, rental income, alimony, child support, unemployment, and workers’ compensation are all counted. Income-based applications are processed through Revenue Cycle Management and typically result in a decision within three to four weeks.
HCAP is Ohio’s state-required hospital safety net program and it runs parallel to Cleveland Clinic’s own financial assistance policy. It provides free basic medically necessary hospital services to Ohio residents whose income is at or below 100% of the Federal Poverty Guidelines β and critically, it applies to both insured and uninsured patients. If you’re an insured Ohio resident with an income at or below the 100% FPL threshold, HCAP may cover costs that your insurance doesn’t address. HCAP requires a separate application from the standard Cleveland Clinic financial assistance form. All applicants must cooperate with the Medicaid screening process to be considered β failure to do so disqualifies the application.
This is the pathway most patients never discover. If your outstanding balance from a single episode of care at Cleveland Clinic exceeds 25% of your annual family income, you may qualify for financial assistance regardless of whether your income is above the standard 400% FPL threshold. This provision was designed for families who are generally financially stable but face a catastrophic medical event β the kind of bill that a middle-income household simply cannot absorb. This pathway is not automatic β you must contact Cleveland Clinic, specifically explain that your balance exceeds 25% of your annual income, and request a financial assistance application under the Catastrophic Balance provision. The income threshold exclusion applies only to patients where Cleveland Clinic is out-of-network for their insurance.
Patients undergoing an extreme personal or financial hardship β including those with a terminal illness or other catastrophic medical condition β may request consideration for assistance even if they don’t meet any income criteria. This is evaluated on a case-by-case basis by Cleveland Clinic’s Central Billing and Collections Office Manager. The policy is deliberately broad here because it’s designed to catch situations the income formula alone cannot fairly address. To trigger this pathway, contact Cleveland Clinic and explicitly state that you are experiencing an extreme hardship β use those specific words. Bring documentation of your circumstances (a letter from your physician describing your condition, evidence of financial hardship, or other supporting documentation) when you call or visit.
This pathway applies to patients whose treatment can only be provided by Cleveland Clinic medical staff, or who would benefit from continued care at Cleveland Clinic for continuity purposes. A Cleveland Clinic physician must recommend this designation β it is initiated internally when a patient is identified during scheduling or admission as having special medical circumstances. This is particularly relevant for patients with rare conditions, complex cases requiring subspecialty expertise, or ongoing treatment plans that would be disrupted by transferring care. If you believe your condition qualifies, ask your treating Cleveland Clinic physician directly whether they can initiate a Special Medical Circumstances financial assistance request on your behalf.
The Life Circumstances pathway covers patients who are homeless or who are deceased without a known spouse or estate, and who have outstanding Cleveland Clinic balances or single episodes of care that don’t otherwise qualify under income-based criteria. This provision ensures that the most financially vulnerable patients β including those without stable housing β are not excluded from assistance simply because their situation doesn’t fit neatly into a standard income verification process. For homeless patients, contact a Patient Financial Advocate at any Cleveland Clinic location and explain your housing situation. The advocate will initiate the application internally.
Ohio’s Hospital Care Assurance Program is a state-mandated benefit that runs alongside Cleveland Clinic’s own financial assistance β and unlike the Clinic’s program, it applies to both insured and uninsured patients at the lowest income levels.
HCAP provides free emergency and medically necessary hospital-level services to Ohio residents who qualify. It is Ohio’s version of the federally required Disproportionate Share Hospital program. Eligibility requires Ohio residency and income at or below 100% of the Federal Poverty Guidelines β roughly $15,960 for a single person. Ohio residents who receive General Assistance or Disability Assistance payments automatically qualify. HCAP covers basic medically necessary hospital services only β not physician fees in most community hospital settings.
This is the point where many patients get tripped up. Applying for Cleveland Clinic’s financial assistance program does not automatically enroll you in HCAP, and vice versa. They are parallel programs with separate application forms and separate determination processes. If you’re an Ohio resident with income at or below 100% FPL, ask specifically for both applications at the same time. A Patient Financial Advocate can tell you which services are covered under which program. Also note that HCAP covers hospital services only β physician fees at community hospitals are generally not covered under HCAP even if the physician is a Cleveland Clinic employee.
Cleveland Clinic’s Patient Financial Services team handles both HCAP and the standard financial assistance application. Call 866-621-6385 and ask specifically: “I’m an Ohio resident and I’d like to apply for both the HCAP program and the Cleveland Clinic financial assistance program at the same time.” Having both conversations in one call saves time and ensures you don’t miss a benefit you’re entitled to. You can also pick up forms at any emergency department, admissions area, or Patient Financial Advocate office, or request them by mail through the same number.
Cleveland Clinic’s sliding scale is tied to the Federal Poverty Level. The 2026 FPL baseline for the contiguous 48 states is approximately $15,960 for a single person, with roughly $6,200 added for each additional household member. The table below reflects the general framework β exact percentages may vary by specific facility and program.
| Income Range | Type of Assistance | Who It Covers | Key Notes |
|---|---|---|---|
| At or below 100% FPL ~$15,960 (1 person) |
Free care β 100% discount | Uninsured patients; Ohio insured patients via HCAP | HCAP automatically covers Ohio residents; standard FA covers others |
| 101%β180% FPL ~$16,120β$28,728 (1 person) |
Sliding scale discount from AGB rate | Uninsured patients | Discount proportional to income; Medicaid screening required |
| 181%β250% FPL ~$28,888β$39,900 (1 person) |
Sliding scale β larger share owed | Uninsured patients | Rate tied to AGB; still significantly below chargemaster list price |
| 251%β400% FPL ~$40,060β$63,840 (1 person) |
Discounted to AGB (insured rate) | Uninsured patients; certain insured patients | You pay the same rate as insured patients β not the inflated list price |
| Over 400% FPL Over $63,840 (1 person) |
No income-based assistance β but other pathways may apply | All patients | Catastrophic Balance (25% rule), Exceptional Circumstances, or Special Medical still possible |
| Any income β balance >25% of annual income | Catastrophic Balance consideration | Uninsured + insured (in-network only) | No income ceiling; must request this pathway explicitly |
FPL figures are approximate for a single-person household in the 48 contiguous states. Add approximately $6,200 for each additional household member. Alaska and Hawaii have higher FPL thresholds. All income figures are gross (before taxes and deductions). Exact discount percentages and tier cutoffs vary by Cleveland Clinic facility β confirm current thresholds with a Patient Financial Advocate for your specific location.
Incomplete applications delay processing by weeks. Having everything in one place before you start β whether applying online, by phone, in person, or by mail β means a decision arrives in days rather than a month.
- Most recent federal tax return β the full 1040, including all schedules. Self-employed patients must include Schedule C showing business income and expenses.
- Last two to four pay stubs β for all adults in the household who are currently employed. If recently laid off, bring your most recent stubs from your previous employer plus documentation of termination or unemployment filing.
- Social Security or SSDI/SSI award letter β the most recent benefit verification letter from the Social Security Administration showing your current monthly benefit amount.
- Benefit award letters for SNAP, housing assistance, pension, or disability β any government benefit you or a household member receives counts as income.
- Proof of residence β a utility bill, lease agreement, or official mail in your name at your current address. Ohio residency documentation is required for HCAP.
- Itemized medical bills β the specific Cleveland Clinic bills you’re seeking assistance for, including dates of service and account numbers.
- Your Social Security number β and those of all household members listed on the application.
If you were not required to file a federal tax return for the most recent tax year, you will need a Verification of Non-Filing letter from the IRS plus documentation of any income sources you have. Request the IRS letter at IRS.gov or by calling 1-800-829-1040. Additionally, Cleveland Clinic may use third-party income verification databases to help complete your application if documents are missing β they will notify you if additional information is needed and give you a reasonable opportunity to provide it. Self-employment income must be documented with a Schedule C even if you operate as a sole proprietor without a formal business filing.
Cleveland Clinic’s policy counts gross annual family income from all household members, including all of these sources: wages, tips, salaries, Social Security retirement benefits, Social Security Disability (SSDI), Supplemental Security Income (SSI), pension income, retirement distributions, interest and dividend income, rental income, alimony, child support, unemployment compensation, and workers’ compensation. Many patients assume that SSDI or SSI won’t push them above the threshold β they count just like any other income source. The household for income purposes includes the patient, their spouse, and all children under 18 living in the home.
Cleveland Clinic accepts applications through four channels. Online is the fastest. In-person gives you access to a Patient Financial Advocate who can fill out the form with you. Mail and fax are options when neither works. All four go to the same Revenue Cycle Management team for processing.
The online application at clevelandclinic.org/financialassistance allows you to complete the form, upload income documents, and submit everything in one session. You can also schedule a callback with a Patient Financial Advocate through the same portal if you have questions mid-application. Upload all documents at the time of submission β applications sent without documentation go to a pending queue and wait until documents arrive, which delays the decision by weeks. After submission, you can check your application status at any time by calling 866-621-6385 and following the automated prompts.
Applications can be submitted in person at any Cleveland Clinic location β emergency departments, admissions areas, or directly at a Patient Financial Advocate’s office. This is the best option if you’re unsure what documents you need, if you want help filling out the form, or if you’re already at the facility. Patient Financial Advocates will attempt to contact all uninsured patients by phone at the time of scheduling β if you’re called before your appointment, that conversation can be the start of your application. You can also apply at any point during your care, not just before or after β the policy allows applications during treatment as well.
Paper applications can be mailed or faxed with your income documentation attached. Mail your completed application to CCF-Financial Assistance Application, PO Box 932553, Cleveland, OH 44193. The fax number for standard Ohio applications is 1-800-687-9901. Rehabilitation Hospital patients use a different fax number listed on their specific application form. Use certified mail or keep a fax confirmation page β if a dispute arises about whether documents were received, the confirmation is your proof. Mail and fax applications typically take longer to process than online submissions, so allow additional time for a decision.
If your financial situation involves more than the Cleveland Clinic bill β prescription costs, housing instability, food insecurity, or navigating multiple public benefit programs β a Cleveland Clinic social worker can help you identify resources beyond what the financial assistance policy covers. Call 216-444-6554 to speak with a social worker. Social workers can also make internal referrals for exceptional circumstances and special medical circumstances financial assistance when a physician designation alone isn’t enough. This call is free, confidential, and available to any Cleveland Clinic patient regardless of insurance status or income level.
Apply online at clevelandclinic.org/financialassistance immediately β upload your most recent tax return and last two pay stubs in the same session. If your income is below 400% of the Federal Poverty Level (approximately $63,840 for one person), you’re within the eligibility range for some level of assistance. While your application is pending, extraordinary collection actions must pause. If your income is above that threshold but the bill is more than 25% of your annual family income, call 866-621-6385 and specifically ask about the Catastrophic Balance provision β state that your bill exceeds 25% of your annual income. Also confirm you are cooperating fully with any calls from ElevatePFS or Firstsource, as failing to respond disqualifies your application.
Ask your Patient Financial Advocate specifically about HCAP β the Ohio Hospital Care Assurance Program. HCAP covers both insured and uninsured Ohio residents at or below 100% FPL for basic medically necessary hospital services, and is a separate program from the standard financial assistance pathway. If your income is above 100% FPL, the standard financial assistance program for insured patients applies only in limited situations: your insurance doesn’t cover the specific service, you’ve exhausted your lifetime maximum benefits, or exceptional circumstances apply. Call 866-621-6385 and ask for a Patient Financial Advocate who can assess both HCAP and the standard program simultaneously for your situation.
Call 866-621-6385 and say explicitly: “I have a terminal illness and I am experiencing extreme financial hardship β I need to speak with someone about the Exceptional Circumstances financial assistance provision.” That specific language triggers the right conversation. Also ask whether your physician can initiate a Special Medical Circumstances designation, which is a separate pathway that can apply if your treatment requires Cleveland Clinic’s specific expertise. Simultaneously, call the social work line at 216-444-6554 β social workers can make internal referrals and coordinate multiple programs at once. Bring a letter from your physician describing your diagnosis and prognosis to any in-person meeting, as this documentation materially strengthens an Exceptional Circumstances application.
Check the date on your first billing statement. The financial assistance window is 240 days from that date β or, if longer, from the date the collection agency returned the account to Cleveland Clinic. If you’re still within that window, apply immediately at clevelandclinic.org/financialassistance or call 866-621-6385. The moment your application is submitted, extraordinary collection actions (wage garnishments, legal judgments, credit reporting) must pause. Cleveland Clinic’s own policy confirms they do not report to credit bureaus or pursue wage garnishments through their collection agencies β so if a collector is threatening those actions, contact Cleveland Clinic directly to confirm whether this is a third-party acting outside their policy. Do not pay a collection agency the full amount without first checking whether you qualify for financial assistance.
The financial assistance program explicitly does not cover prescriptions. For prescription help, call 866-650-6337 to be referred to pharmaceutical manufacturer patient assistance programs, or speak with a social worker at 216-444-6554 who can identify programs specific to your medications and situation. NeedyMeds.org is a free searchable database of manufacturer patient assistance programs β searchable by drug name β that doesn’t require a referral. For ongoing specialty medications prescribed as part of a Cleveland Clinic treatment plan, ask your treating physician’s office whether a Patient Access Manager or specialty pharmacy liaison is available in their department β many Cleveland Clinic specialty programs have internal staff dedicated to securing medication funding for patients who cannot afford it.
- You must be informed about financial assistance β every time you receive a billing statement, Cleveland Clinic is required to notify you that financial assistance is available and how to apply.
- You cannot be charged more than the AGB rate β even if you don’t qualify for income-based assistance, you cannot be charged more than the Amounts Generally Billed to insured patients for the same services. You can always ask for the AGB rate.
- Collections cannot begin during a pending application β extraordinary collection actions (credit reporting, wage garnishments, legal actions) must pause while your application is under review.
- You have 240 days to apply β extraordinary collection actions cannot begin until 240 days after your first billing statement, giving you that window to apply.
- You must receive a written response β if approved, you receive a letter stating your coverage level. If denied, you receive the reason for denial. You have the right to provide additional information if documents were missing.
- The policy cannot discriminate β eligibility is determined without regard to race, gender, age, sexual orientation, religious affiliation, or immigration status. Ohio residents also have protection through state law.
- Financial assistance application + Patient Financial Advocate: 866-621-6385 Β· MonβFri 8amβ5pm EST
- Apply online: clevelandclinic.org/financialassistance
- Mail application: CCF-Financial Assistance, PO Box 932553, Cleveland OH 44193
- Fax (Ohio standard): 1-800-687-9901
- Billing department: 216-444-2200
- Social Work (prescriptions + community resources): 216-444-6554
- Prescription assistance referrals: 866-650-6337
- Cleveland Clinic Florida (Weston): same application portal Β· 866-621-6385
- Itemized bill request: 866-621-6385 Β· MonβFri 8amβ5pm EST
This guide is for informational purposes only and is not affiliated with, sponsored by, endorsed by, or produced in partnership with Cleveland Clinic. Program details, income thresholds, eligibility rules, contact numbers, and policy specifics are based on publicly available Cleveland Clinic Financial Assistance Policy documents revised January 2026, and may change. Individual facility policies β particularly for Rehabilitation Hospitals, Select Cleveland Hospitals, and Florida locations β may differ from the general policy described here. Always contact a Cleveland Clinic Patient Financial Advocate directly to confirm current eligibility requirements for your specific facility and situation. Nothing in this guide constitutes legal, medical, or financial advice.