Financial Assistance

At Compass Memorial Healthcare (CMH) we are committed to delivering remarkable healthcare that makes a difference in the communities we serve. We understand that some patients may face financial challenges and may be unable to pay for the care they receive.

Financial Assistance Program

Compass Memorial Healthcare provides financial assistance to eligible individuals who are uninsured or underinsured and receive emergency or other medically necessary care. Eligibility is determined based on financial need using the Department of Health and Human Services Federal Poverty Guidelines (FPG). Individuals with a household income at or below 300% of the FPG may qualify for assistance.

How to Obtain a Copy of Our Policy and Application

You can access a copy of our Financial Assistance Policy and application form in the following ways:

  1. Online: Download Spanish and/or English Application document and submit to Compass Memorial Healthcare - Business Office, 300 W. May Street, Marengo, Iowa 52301
  1. In Person: Copies are available in the registration and waiting areas at:
    • Compass Memorial Healthcare
    • Marengo Family Medical Clinic
    • Williamsburg Family Medical Clinic
  2. By Phone: Call 319-642-5543 to request a free copy of the policy and application.
  3. By Email: Email our financial counselor to request a free copy of the policy and application. 

How to Apply

You can apply at any point during the scheduling or billing process. To apply, complete the Financial Assistance Application and provide the required documentation. Applications can be submitted: in person, by mail, or by email.  

Mail Completed Applications To:

Compass Memorial Healthcare – Business Office
300 W. May Street
Marengo, Iowa 52301

Application Deadline

Applications must be submitted within 240 days of the date of your first bill for the care received.

Financial Assistance Application

Financial Assistance Policy

Required Documentation:

  • W-2 forms and last 4 pay stubs or income vouchers for all household members
    • If you do not file taxes or your situation has changed, we will also accept: 
      • Copy of last month’s checking and/or savings statements
      • Copy of Social Security award letter
      • Copy of unemployment benefits
      • Copy of most recent certified Financial Statement (business owners/self-employed)
  • Iowa Medicaid approval or denial
  • Most recent federal tax return
    • If you do not file taxes or your situation has changed, we will also accept: 
      • Copy of last month’s checking and/or savings statements
      • Copy of Social Security award letter
      • Copy of unemployment benefits
      • Copy of most recent certified Financial Statement (business owners/self-employed)

Uninsured and Underinsured 

Uninsured individuals and those approved for financial assistance will not be charged more than the amounts generally billed to patients with Medicare for emergency or medical care.

Need Help?

If you need assistance with the application process, have questions on your bill, insurance claim, or if you would like to update your information, contact our Business Office. 

Phone: 319-642-8165
Email: CMH-FinancialCounselor@compassmemorial.org
Hours: Monday – Friday, 8:00 AM – 4:30 PM.