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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. If you believe you may be eligible for Financial Assistance we encourage you to apply. Financial assistance application forms can be completed at no charge in MyChart or can be downloaded below.

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Please look for the clinic or hospital location where you receive your care.

La Crosse and Onalaska (GLMC)

In order to qualify for potential financial assistance through Gundersen Health System for medical bills, you will need to complete the Financial Assistance Application and include the items on the checklist.

Documents:

Financial Assistance Application

Apply for Medicaid

Plain-language Summary

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

Tsab Cai Txog Kev Pab Nyiaj Them Nqi (Hmong)

Política de asistencia financiera (Spanish)

Kaalmada Maaliyadda (Somali)

Pomoc finansowa (Polish)

Self-Pay Billing & Collection Policy

Please send completed information 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.

Boscobel, Fennimore and Muscoda (Boscobel Area)

Gundersen Boscobel Area Hospital and Clinics includes the hospital and medical clinics in Boscobel, Fennimore and Muscoda.

Financial Assistance

In order to qualify for potential financial assistance through Gundersen Boscobel Area Hospital and Clinics for medical bills, you will need to complete the Financial Assistance Application and include the items on the checklist.

Documents:

Financial Assistance Application

Apply for Medicaid

Plain-language Summary

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

Nrhiav nyiajtxiag pab (Hmong)

Política de asistencia financiera (Spanish)

Kaalmada Maaliyadda (Somali)

Pomoc finansowa (Polish)

Self-Pay Billing & Collection Policy

Please send completed information to:

Gundersen Boscobel Area Hospital and Clinics
Customer Financial Services
205 Parker Street
Boscobel, WI 53805

If you have any questions, call us at (608) 375-4112.

Friendship, Westfield (Moundview)

Gundersen Moundview Hospital and Clinics includes the Hospital and Clinics in Friendship and Westfield.

Financial Assistance

In order to qualify for potential financial assistance through Gundersen Moundview Hospital and Clinics for medical bills, you will need to complete the Financial Assistance Application and include the items on the checklist.

Documents:

Financial Assistance Application

Apply for Medicaid

Plain-language Summary

Financial Assistance Policy

Financial Assistance Policy

  • 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

Tsab Cai Txog Kev Pab Nyiaj Them Nqi (Hmong)

Pomoc finansowa (Polish)

Kaalmada Maaliyadda (Somali)

Política de asistencia financiera (Spanish)

Self-Pay Billing & Collection Policy

Please send completed information to:

Gundersen Moundview Hospital and Clinics
Financial Services
402 W. Lake Street, Friendship, WI 53934
If you have any questions, call us at (608) 339-3331.

Hillsboro, Wonewoc, Elroy (St. Joseph's)

Gundersen St. Joseph's Hospital and Clinics includes the Hospital and Clinics in Hillsboro, Wonewoc and Elroy.

Financial Assistance

In order to qualify for potential financial assistance through Gundersen St. Joseph's Area Hospital and Clinics for medical bills, you will need to complete the Financial Assistance Application and include the items on the checklist.

Documents:

Financial Assistance Application

Apply for Medicaid

Plain-language Summary

Financial Assistance Policy

Self-Pay Billing & Collection Policy

Please send completed information to:

Gundersen St. Joseph's Area Hospital and Clinics
Customer Financial Services
400 Water Avenue, Hillsboro, WI 54634

If you have any questions, call us at (608) 489-8198.

Wabasha, Alma (St. Elizabeth's)

Gundersen St. Elizabeth's Hospital and Clinics includes the Hospital and Clinics in Wabasha and Alma.

Financial Assistance

In order to qualify for potential financial assistance through Gundersen St. Elizabeth's Hospital and Clinics for medical bills, you will need to complete the Financial Assistance Application and include the items on the checklist.

Documents:

Financial Assistance Application

Plain-language Summary

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

Tsab Cai Txog Kev Pab Nyiaj Them Nqi (Hmong)

Política de asistencia financiera (Spanish)

Kaalmada Maaliyadda (Somali)

Pomoc finansowa (Polish)

Self-pay Billing and Collection Policy

Please send completed information to:

Gundersen St. Elizabeth's Hospital and Clinics
Patient Accounts Department
1200 Grant Boulevard West, Wabasha, MN 55981

If you have any questions, call us at (651) 565-5545

West Union, Postville and Fayette (Palmer)

Gundersen Palmer Hospital and Clinics includes the Hospital and Clinics in West Union, Postville and Fayette.

Financial Assistance

In order to qualify for potential financial assistance for medical bills, you will need to complete the Financial Assistance Application and include the items on the checklist.

Documents:

Financial Assistance Application

Apply for Medicaid

Plain-language Summary

Financial Assistance Policy

Self-Pay Billing & Collection Policy

Please send completed information to:

Gundersen Palmer Lutheran Health Center
112 Jefferson Street
West Union, IA 52175

If you have any questions, call us at (563) 422-3811 from 7:30 a.m. to 4:30 p.m., Monday through Friday.

Whitehall, Blair and Independence (Tri-County)

Gundersen Tri-County Hospital and Clinics includes the Hospital and Clinics in Whitehall, Blair and Independence.

Financial Assistance

In order to qualify for potential financial assistance for medical bills, you will need to complete the Financial Assistance Application and include the items on the checklist.

Documents:

Financial Assistance Application

Apply for Medicaid

Plain Language Summary

Financial Assistance Policy

Self-Pay Billing & Collection Policy

Please send completed information to:

Gundersen Tri-County Hospital and Clinics
18601 Lincoln Street
Whitehall, WI 54773

If you have any questions, call us at (715) 538-4361 ext. 64207.

All other clinic locations

In order to qualify for potential financial assistance through Gundersen Health System for medical bills, you will need to complete the Financial Assistance Application and include the items on the checklist.

Documents:

Financial Assistance Application

Apply for Medicaid

Plain-language Summary

Financial Assistance Policy

Self-Pay Billing & Collection Policy

Please send completed information 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.
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1900 South Ave.
La Crosse, WI 54601

(608) 782-7300
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