Financial Assistance

“We’re Here To Help!”

Vermont offers several options to help people get health insurance coverage. These include Medicaid, Dr. Dynasaur, VHAP, Catamount Health, and VHAP-Pharmacy. Together, these programs are called Green Mountain Care. Each program has different eligibility, but Vermonters with incomes up to 300 % of the federal poverty level can qualify. To learn more about these programs go to or call 1-800-250-8427. The state also offers help with prescription drugs through the Attorney General’s Prescription Drug Finder.

North Country Hospital understands health care costs can present a financial hardship to families and individuals. It is our intent to help those who meet certain income and asset guidelines. You may request an application from the Registration Office (in the main lobby), the Emergency Room Registration desk or the Financial Counseling office (off the main lobby), or call the telephone number listed below to have one mailed to you.

Instructions for applying for Financial Assistance at North Country Hospital

In order to promptly process your application for financial assistance, the following is requested with your application:

1. Medicaid “Notice of Decision” – applicants are required to apply for medical health care benefits through the Vermont. Dept. of Prevention, Assistance, Transition, and Health Access, 100 Main St. Suite 240, Newport, Vermont. Telephone 802-334-6504

2. Proof of Income – consists of the following:

A. The previous year income tax return including all forms and schedules.

B. A Social Security statement or check, or a bank statement showing direct deposits of your monthly income (social security/disability).

C. Medicaid (General Assistance).

D. Four recent paychecks/unemployment checks.

E. Two consecutive monthly bank statements

We ask that the application be filled out completely and signed.

If you have any questions about the application process, or need assistance in completing the application, you are encouraged to call our Financial Counseling office at (802)334-3274/3273. Our office hours are 8:00 to 4:30, Monday through Friday.

2013 Income Guidelines
Family Size U.S. Poverty Guideline
100% coverage
200% of U.S. Poverty Guideline
Discounted Coverage
300% of U.S. Poverty Guidelines
1 $11,170 <$22,340 <$33,510
2 $15,130 <$30,260 <$45,390
3 $19,090 <$38,180 <$57,270
4 $23,050 <$46,100 <$69,150
5 $27,010 <$54,020 <$81,030
6 $30,970 <$61,940 <$92,910
7 $34,930 <$69,860 <$104,790
8 $38,890 <$77,780 <$116,670
For each additional person, add $3,960


If you qualify at 250% of poverty guideline and are female you may qualify for Ladies First benefits.

Go to or let us know and we will send you an application.

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