Financial Assistance
Financial Assistance Plain Language Summary
Updated August 2026
Cimarron Memorial Hospital offers financial assistance to eligible patients who cannot pay the full cost of emergency or other medically necessary care. Help may include free care or a discount on the patient-responsibility portion of a hospital bill.
Who May Qualify?
Eligibility is based mainly on gross household income, household size, financial hardship, and reasonable cooperation with the application process. The standard assistance schedule uses the current Federal Poverty Guidelines (FPG):
- At or below 100% FPG: 100% adjustment (free care)
- Above 100% through 150% FPG: 75% adjustment
- Above 150% through 200% FPG: 50% adjustment
- Above 200% through 250% FPG: 25% adjustment
- Above 250% FPG: No standard assistance; extraordinary financial hardship may still be considered.
Financial assistance applies to eligible emergency and other medically necessary hospital services. Some services provided by independent clinicians or other providers may not be covered. Please review the Financial Assistance Providers List or contact the Business Office for more information.
How Do I Apply?
Complete the Financial Assistance Application and return it with available documents supporting household income, such as a recent federal tax return, W-2, two recent pay stubs, Social Security or retirement statements, unemployment documentation, or other available proof.
If you cannot provide a requested document, explain why on the application. You may also describe extraordinary financial hardship.
Submit the completed application and supporting documents to the Cimarron Memorial Hospital Business Office in person or by mail. Registration or Business Office staff can help you complete the application at no charge.
Get Free Copies or Assistance
In person:
Business Office
Cimarron Memorial Hospital
100 South Ellis
Boise City, OK 73933
By mail:
Call the Business Office at
(580) 544-2501
and ask for a free copy of the Financial Assistance Policy and/or Application to be mailed to you.
Mail completed applications to:
Cimarron Memorial Hospital
Attn: Business Office
P.O. Box 1059
Boise City, OK 73933
Questions or application help: Business Office, (580) 544-2501
You may also view or print the Financial Assistance Plain Language Summary as a PDF .
Important: A patient who is eligible for financial assistance will not be charged more for emergency or other medically necessary care than the amounts generally billed to individuals who have insurance covering that care.
Emergency care is available regardless of ability to pay or insurance status.
Emergency Care
Emergency care is available regardless of your ability to pay or insurance status.
Cimarron Memorial Hospital provides emergency medical screening and, when an emergency medical condition is identified, stabilizing treatment within the hospital’s capabilities or an appropriate transfer, regardless of the patient’s ability to pay or insurance status.
Financial considerations will not delay or prevent an appropriate medical screening examination or stabilizing treatment.
Self-Pay Discount
Patients who do not have insurance are eligible for a 50% self-pay discount when their portion of the bill is paid in full on the day of service or within 30 days of service.
Financial Assistance
Eligible patients may qualify for charity care or discounted care based on their financial circumstances.
Information about eligibility requirements and how to apply is available in our Financial Assistance Policy and Financial Assistance Application .
Payment Plans
If you are unable to pay your balance in full, payment plans are available. Our Business Office can work with you to establish a payment arrangement that allows you to pay your balance over time without creating an unnecessary financial hardship.
Please contact the Business Office at 580-544-2501 to discuss available payment arrangements.
How to Apply
To apply for Financial Assistance:
- Download and complete the Financial Assistance Application .
- Provide the supporting documentation requested with your application.
- Submit your completed application and supporting documentation to the Business Office.
- Your application will be reviewed according to the eligibility requirements outlined in the Financial Assistance Policy .
- You will be notified of the determination.
Payment Options
Pay In Person
Payments may be made in person at our Business Office:
Cimarron Memorial Hospital100 South Ellis
Boise City, OK 73933
Pay By Mail
Payments may also be mailed to:
Cimarron Memorial HospitalP.O. Box 1059
Boise City, OK 73933
Pay Online
Online payments can be made securely through our online payment portal.
Make an Online PaymentCash, Check, Money Order, Credit Card, and Debit Card.
Questions About Financial Assistance?
If you have questions about Financial Assistance or need assistance completing the application, please contact our Business Office at:
580-544-2501