Beaumont Health Financial Assistance Policy Summary Locations for Assistance Thank you for choosing Beaumont for your healthcare needs. Our goal is to provide all patients with high quality health care services regardless of their Beaumont Hospital – Dearborn financial circumstances. Beaumont Health offers financial assistance to Attention: Benefit Advisors uninsured and underinsured patients for emergency and other medically 18101 Oakwood Blvd. necessary in accordance with our Financial Assistance Policy. Dearborn, Michigan 48124 Telephone: (248) 577-9205 Who is Eligible Beaumont Hospital – Farmington Financial assistance is offered to patients who are uninsured or underinsured and Hills who satisfy requirements stated in our Policy. Eligibility for financial assistance is Attention: Benefit Advisors based on multiple factors, including insurance coverage and other sources of 28050 Grand River Farmington Hills, Michigan 48336 payment (such as for personal injury claims), income (the Federal Poverty Telephone: (248) 577-9205 Guidelines are used to determine the amount of financial assistance offered), family size and assets. Beaumont Hospital – Grosse Pointe Attention: Benefit Advisors Financial Assistance Offered 468 Cadieux Road Depending on the patient’s ability to pay, as determined in accordance with our Grosse Pointe, MI 48230 Telephone: (248) 577-9205 Policy, free care or partial financial assistance may be provided. Financial assistance is limited to medical care provided at a Beaumont Health hospital by Beaumont Hospital – Royal Oak the hospital and participating providers. A complete list of participating providers Attention: Benefit Advisors 3601 W. 13 Mile Road can be found at www.beaumont.org/patients-families/billing/financial-assistance. Royal Oak, MI 48073 How to Apply for Financial Assistance Telephone: (248) 577-9205 A request for Financial Assistance may be made by the patient, family member, Beaumont Hospital – Taylor close friend or associate of the patient by filing an application in accordance with Attention: Benefit Advisors the requirements stated in our Policy. Beaumont Benefit Advisors are available to 18101 Oakwood Blvd. Dearborn, Michigan 48124 help patients apply for financial assistance by phone at (248) 577-9205 or in Telephone: (248) 577-9205 person at the offices listed in this Summary, Monday through Thursday, between 8:00 a.m. and 6:30 p.m and Friday 8:00am and 4:30pm. An application may be Beaumont Hospital – Trenton Attention: Benefit Advisors sumitted in-person at one of the offices listed in this Summary or by mailing the 18101 Oakwood Blvd. completed application form and supporting documentation to: Beaumont Health Dearborn, Michigan 48124 System, Customer Service Department, 26901 Beaumont Blvd, Southfield, MI Telephone: (248) 577-9205 48033. Beaumont Hospital – Troy Where to Obtain Copies of Our Financial Assistance Policy and Application Attention: Benefit Advisors 44201 Dequindre Road Our Financial Assistance Policy and Application are available free of charge by Troy, Michigan 48085 calling (248) 577-9205 and requesting a copy by mail or email. Copies also are Telephone: (248) 577-9205 available in the Admissions areas at all Beaumont Health hospitals, as well as all Beaumont Hospital – Wayne Emergency Department locations. In addition, the Policy and Application are Attention: Benefit Advisors available online at www.beaumont.org/patients-families/billing/financial-assistance 18101 Oakwood Blvd. for downloading and printing. Dearborn, Michigan 48124 Telephone: (248) 577-9205 Translations are Available Translations of our Financial Assistance Policy, the Application and this Summary are available at https://www.beaumont.org/patients-families/billing/financial- assistance. Charges Will Not Exceed Amounts Generally Billed. A patient determined to be eligible for financial assistance under our Policy will not be charged more than amounts generally billed for emergency or other medically necessary care to patients who have insurance for such care. .