Charity care is a state-mandated and partially state-funded program that allows uninsured or underinsured people to receive inpatient and outpatient care at a reduced cost. Only people who meet certain income and asset criteria are eligible to receive charity care.
Visit the Department of Health and Senior Services to see if you may qualify for charity care.
New Jersey law states that charity care may be provided for any "medically necessary" services as determined by a physician. Virtua will treat anyone in medical need, regardless of their ability to pay. However, charity care is not an entitlement or a medical insurance policy, and should only be used as a last resort.
To learn more about the State of New Jersey's Charity Care Program, read our frequently asked billing questions or call toll-free 1-888-625-2890 from Monday through Friday from 8:30 am to 5 pm.
If you are uninsured but do not qualify for state charity care, you may be eligible for the Virtua Charity Assistance Program. The program aids people who make too much money to receive charity care but have no health insurance.
- Affidavit of Personal Recognition (PDF)
- Affidavit of Separation (PDF)
- Affidavit of Unreported Income (PDF)
- Affidavit on Behalf of Patient (PDF)
- Patient Attestation (PDF)
- Spouse/Other Responsible Party Certifications (PDF)
- Statement of No Contact (PDF)
Please forward Charity Care Applications and/or any supporting documents by fax or mail.
Mail to: Sierra Health Group, LLC
440 Franklin Street
Bloomfield, NJ 07003
Fax to: 888-420-7704