Check Eligibility – INS – Gibson Area Hospital

Financial Assistance

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Thanks for using our Eligibility Checker for Financial Assistance! Answer the following questions to see if you may be eligible for a discount on your Gibson Area Hospital & Health Services bills.

Name*

First Last

Date of Birth

Do you have health insurance?*

Yes

Including yourself, how many people are in your immediate family?*

Please enter a number from 1 to 10.

What is your estimated gross MONTHLY immediate family’s income?*

Please enter a number from 0 to 1000000.

What is your total household assets?*

Please enter a number from 0 to 1000000.