Financial Assistance

Need help paying for care? We are here to help explain your options.

  • 1. Talk to a financial counselor

    Our financial counselors are here to help. Call them at 206-987-3333 or visit them at our main Seattle campus. Patients staying overnight in the hospital can call and make an appointment for a counselor to come to their room.

    Financial counselors can help you:

    Apply for Medicaid

    Financial counselors can help you apply for Washington (Apple Health) and other state Medicaid programs in Montana, Idaho and Alaska.

    Medicaid (state medical assistance) can often pay for part or all of your child’s health care expenses, even if you are not eligible for other forms of aid from the state. Medicaid can also help pay for healthcare bills from other providers besides Seattle Children’s. You may be required to apply for Medicaid before we can consider you for financial assistance.

    Find insurance on your state health insurance exchange

    They are certified experts for Washington’s Insurance Exchange and can help you find a plan on your state’s own exchange. Learn more about plans that include Seattle Children’s.

    Set up short-term, interest-free payment plans

    Apply for Seattle Children’s Financial Assistance Program

    If none of the options above work, and you meet the criteria for Seattle Children’s Financial Assistance Program, they can help you apply.

  • 2. Learn about financial assistance

    Seattle Children’s Financial Assistance Policy

    Full Policy (PDF), SpanishRussianVietnameseSomali
    Plain Language Summary of Policy (PDF), SpanishRussianVietnameseSomali

    You may qualify for Seattle Children’s Financial Assistance Program, even if you have insurance.

    Partial Financial Assistance

    Patients may be eligible for Partial Financial Assistance if the patient or responsible party has a gross family income between 401% and 599% of the Federal Poverty Guidelines, as adjusted for family size. In this case, the patient or responsible party is responsible for the applicable portion of the outstanding amount owed, and Seattle Children’s Financial Assistance covers the remaining account balance. 

    Seattle Children’s applies the following discounts for those patients qualifying for Partial Financial Assistance:

    Income as % of Federal Poverty Guidelines

    Discount % from Original Charges

    Patient Responsibility %

    401-449%

    80%

    20%

    450-474%

    75%

    25%

    475-499%

    70%

    30%

    500-524%

    65%

    35%

    525-549%

    60%

    40%

    550-599%

    55%

    45%

     

    Services Excluded from Financial Assistance coverage

    Services which Seattle Children’s considers elective or cosmetic and therefore are not eligible for Financial Assistance include, but are not limited to:

    • Procedures performed only to alter appearance
    • Genetic testing which will not change the plan of care for an existing patient
    • Laboratory testing performed at a laboratory external to Seattle Children’s which does not get processed through the SCH Laboratory Services.
    • Orthodontia for dental malocclusion which is unrelated to an underlying medical condition.
    • Earwell (newborn ear reshaping procedure)
    • Otoplasty for cosmetic purposes
    • Replacement of lost dental retainers
    • Elective educational classes

    Community providers

    Some community providers who see patients in the hospital at Seattle Children’s bill separately for their charges and do not accept Seattle Children’s Financial Assistance for those charges.

    List of providers (PDF).

    Amounts Generally Billed Calculation

    Updated October 2021

    Any patient who is eligible for financial assistance under Seattle Children’s Financial Assistance Policy, and who receives Emergency or other Medically Necessary services provided by the Hospital, will not be billed greater than the Amounts Generally Billed (“AGB”) to patients who are covered under (a) private health insurance/plans; (b) Medicare fee-for-service; and (c) Medicaid.

    Seattle Children’s determines AGB using the “look back method” set forth in federal Treasury Regulations. Seattle Children’s AGB percentage is calculated on an annual basis by dividing: (i) the sum of all allowed amounts for claims that have been paid by Medicaid, Medicare fee-for-service, and all private health insurers, by (ii) the sum of the associated gross charges for those claims. The resulting AGB percentage is applied to a patient’s balance, after meeting Financial Assistance eligibility criteria, to determine the amount due from patients qualifying for Partial Financial Assistance. Seattle Children’s AGB percentage is applicable as of October 1 each year. 

    Seattle Children’s AGB percentage is 48%.

  • 3. Apply for financial assistance