Rio Grande Hospital and Clinics are dedicated to providing medically necessary health care services; these services are accessible to all, regardless of age, gender, geographic location, cultural background, physical mobility, or ability to pay. We are committed to providing health care services and acknowledge that in some cases the patient will not be financially able to pay for the services received. In those particular cases the patient will be screened, and a determination of eligibility for financial assistance will be initiated prior to or at the time of admission.

Download the Financial Assistance Guidelines & Policies

Sliding Fee Scale Assistance Available

National Health Service Corps Promise – English

National Health Service Corps Promise – Spanish

Download Financial Assistance Guide – English

Download Financial Assistance Guide – Spanish

Federal Poverty Guidelines Sliding Fee Scale 2018

What is Medicaid?

Medicaid is free or low cost public health insurance for Coloradans who qualify. Medicaid can cover your doctor visits, emergency care, preventive care such as screenings and immunizations, and other procedures and treatments.

Who is Eligible?

Financially qualified children ages 0-18 and parents with dependent children

Parents whose income is at or below 133% of the Federal Poverty Level

Children age 6-18 whose family income is at or below 133% of the Federal Poverty Level

Pregnant women at or below 195% of the Federal Poverty Level

How to Apply

For more information please visit www.colorado.gov/hcpf

Requirements for Colorado Indigent Care Program

To schedule a Colorado Indigent Care Program (CICP) rating interview with our Financial Assistance Counselor

call 719-657-4063. You must bring the following information with you at the time of your interview

Residency, Identification, and Citizenship:

• State of Colorado Driver’s License or Colorado Picture I.D., Military I.D. for all household member’s 18 years and older
• Furnish a Social Security Number
• Proof of Citizenship

Gross Earned Income for Household:

• Most recent paystubs for self and spouse
• Most recent Profit/Loss ledger or Business Bank Statements for self-employment

Unearned Income:

• Social Security or Disability Award Letter (SSDI), unemployment award letter, rental income, Workman’s Compensation, spousal maintenance, pensions, settlements, scholarships, bonuses (note: include spouse’s income as well)
• Provide written proof of all other income not listed

Other Verification:

• All medical/pharmacy/dental receipts or statements
• Copy of Health Insurance card
• Proof of payment on health insurance premiums
• Current statement for all checking and savings accounts
• Registration or titles for all vehicles and proof of loan balance if applicable
• Verification of all CD’s, Annuities, Stocks, and Bonds
• Verification of paid child support and childcare

To schedule an appointment call our Financial Assistance Counselor at 719-657-4063
310 County Rd. 14 Del Norte, Co 81132

How to Apply

You can download the CICP (Colorado Indigent Care Program) Application below:

Download the CICP Application

Download the CICP Ability to Pay Scale