Financial Assistance

Howard County Medical Center (HCMC) provides medically necessary services to patients regardless of their ability to pay. HCMC provides assistance to patients who apply and meet the federal poverty guidelines. HCMC works with Early Out Services, a business partner, which handles private pay billing and collection practices. Financial assistance forms are available upon request.

How to apply

To apply for financial assistance, please:

  • Complete the form by either typing or legibly printing ;
  • Attach copies of your verification of income;
  • Sign and date the form;

Send the completed form to:

Howard County Medical Center, Attn: Patient Accounts
PO Box 406
St. Paul, NE 68873


Upon receipt

Upon receipt of the information, HCMC will review the application, and you will be notified of the determination. Failure to submit all requested information will result in denial of financial assistance benefits.

For more information contact Patient Accounts at 308-754-4421.

Downloadable Forms

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