Financial Assistance - Community Care Program

Community Care Program
MercyOne is committed to providing exceptional and compassionate care to all people we serve, regardless of their financial status. To help meet this commitment, the Community Care Program provides assistance to those in need in a fair and non-discriminatory manner. If you do not qualify for state, federal or other assistance programs, the Community Care Program can help you with your out-of-pocket costs.
Community Care applications are available at:

  • Admission and Registration Desks
  • Emergency Department
  • Cashier Window
  • Following the link under “Program Application” on this page
  • Calling a Financial Counselor at 1.800.728.0159

In addition, the Community Care Program policy, which provides more financial assistance details, is available by request by calling 1.800.728.0159 or by following the respective link under “Program Policy” on this page.
Who is eligible for Community Care Program Assistance?
All patients, regardless of race, creed, gender, age or national origin, may apply for Community Care Program assistance. Eligibility is determined on an individual basis, taking into account family size and household income. An application should be submitted within one year of the date of service. Approved applications are valid for 12 months. We may request updated financial information from the patient throughout the 12 month period to determine if eligibility remains the same.
How does the Community Care Program work?
If you receive medical care and need help with your medical bills, our Community Care Program may be able to help. If you qualify, you will receive a discount off of your hospital and/or clinic bill. Eligible patients will not be charged more than the amounts generally billed to individuals with insurance coverage.
What if I do not have health insurance?
If you do not have any health insurance coverage, you may qualify for a discount off your hospital bill through our Community Care Program. We also have Patient Financial Advocates available to assist you in enrolling with state and federal programs, as well as the Marketplace (
What if I have health insurance?
Patients with health insurance can apply for the Community Care Program. This program can help patients with their out-of-pocket expenses. These expenses may be from copays, deductibles and coinsurance after insurance has been billed.
What services qualify for Community Care?
Our Community Care Program applies to all medically necessary patient services that are provided at MercyOne Northeast Iowa, including inpatient, emergency services and other outpatient services charged and billed by MercyOne Clinic, Waterloo Medical Center, Sartori Memorial Hospital and Oelwein Medical Center.
What services do not qualify for Community Care?
Our Community Care Program does not cover the following services:

  • Services that are considered medically unnecessary, including cosmetic procedures or in cases where a package price is arranged in advance, such as a Bariatric procedure.
  • Services to patients who qualify for county, state, federal or other assistance programs.
  • Services that result from a patient going outside their insurance network.
  • Services rendered by physicians and other health care providers not employed by MercyOne Northeast Iowa. Depending on the services you receive, you may receive other bills for services provided by your personal physician and other physicians who are involved in your care. A list of participating and non-participating providers is available by following the respective link below.
  • Community Care assistance does not apply towards prescriptions from MercyOne Waterloo Pharmacy, MercyOne Jesup Pharmacy, MercyOne LaPorte City Pharmacy or MercyOne Home Health services.

How to Apply for Community Care Program Assistance

  • Call one of our Financial Counselors at 319.272.0044 or 1.800.728.0159
  • Ask for a copy of our Community Care application and/or policy be sent to you in the mail by calling a Financial Counselor at the number above.
  • Stop and visit with our Financial Counselors at Waterloo Medical Center anytime Monday - Friday, 8:00 a.m. – 4:30 p.m.:
    • Cashier window at the Covenant Family Pharmacy – enter through the Clinic Entrance (off St. Francis Dr.) and turn right. The pharmacy is on the left.
  • Find an application and our policy by following the respective links below

Once we receive your application, it may take up to 10-15 business days to be approved for Community Care assistance.
Community Care Brochure - English
Community Care Brochure - Bosnian

This information is available in Spanish on request.


To see if your health care provider participates in our Community Care Program, click here.

Program Application

To apply for the Community Care Program, please complete and return our Financial Assistance Form:

Community Care Financial Assistance Form - English   
Community Care Financial Assistance Form - Spanish 
Community Care Financial Assistance Form - Bosnian

Income Limits and Sliding Scale

To help you understand the level of discount offered depending upon Poverty Income Guidelines, click here.

Amounts Generally Billed

Eligible patients will not be charged more than the amounts generally billed to individuals with insurance coverage for emergency or medically necessary care. Click here for more information.

Payment for Services - MercyOne Clinic

Payment for Services Covenant Clinic  
Payment for Services Covenant Clinic - Spanish
Payment for Services Covenant Clinic - Bosnian

Payment for Services - Hospital

Payment for Services Hospital  
Payment for Services Hospital - Spanish
Payment for Services Hospital - Bosnian

Program Policy

Find out more about the Community Care Program requirements, click here.

Billing and Collections Policy

To review our Billing and Collections policy, click here.