Financial Hardship

Financial hardship involves a situation where a person is unable, reasonably, to meet their financial obligations to us. Financial hardship can take place over a limited timeframe or be long-term. Financial hardship can arise from causes such as illness, unemployment or some other unexpected change to income or expenditure expectations. Patients who claim they cannot financially pay any amounts owed will be

In the interest of making a financial hardship determination, a Financial Hardship Waiver Application is needed. The purpose of this application is to enable PKA to evaluate the level of assistance eligibility. The following documents must be submitted with the application:

  • W-2 Withholding Statements from Previous Year
  • Pay stub for most recent pay period showing year-to-date.
  • Any and all documents to support additional income as outlined on the hardship application.