Financial Assistance
Gundersen Health System provides medically necessary care regardless of ability to pay. We can provide financial assistance for medical expenses that you or your family accumulate at any of our facilities.
Need help paying your medical bills?
If you believe you may be eligible for financial assistance through Gundersen Health System for medical bills, we encourage you to apply. You'll need to complete the Financial Assistance Application and include items on the checklist. Application forms can be completed at no charge in MyChart. You may also download the forms below.
Application forms
Financial Assistance Application
Our financial assistance program is available to patients who show financial need. Find applications below.
Financial Assistance Application - English
Financial Assistance Application - Hmong
Financial Assistance Application - Polish
National Health Service Corps
The following Gundersen Health System locations participate in the National Health Service Corps (NHSC) Sliding Fee Discount Program: Gundersen Boscobel Area Hospital and Clinics, Gundersen St. Joseph's Hospital and Clinics, and Gundersen St. Elizabeth's Hospital and Clinics.
NHSC Financial Assistance Application - English
NHSC Financial Assistance Application - Hmong
NHSC Financial Assistance Application - Polish
Please send completed application forms to:
Gundersen Health System
Customer Financial Services
PO Box 4444
La Crosse, WI 54602-4444
If you have any questions, call us at (608) 775-8660 or (800) 362-9567, ext. 58660, from 7:30 a.m. to 5:30 p.m., Monday through Friday.
Financial Assistance Policy
Financial Assistance Policy - English
- Appendix 2: Discount chart based on income and asset thresholds, and the uninsured discount rate
- Appendix 3: Covered providers and departments
- Appendix 4: Amounts Generally Billed (AGB) Percentage
- Appendix 5: Public Access to documents
Financial Assistance Policy - Hmong
Financial Assistance Policy - Polish
Financial Assistance Policy - Somali
Financial Assistance Policy - Spanish
Política de asistencia financiera
Plain Language Summary
Plain Language Summary - English
MyChart bill pay
Not a MyChart user? Sign up now! Or, make a payment as a guest.
Need help? We have step-by-step guides.
