Get ready to apply
Children's Mercy
Financial Assistance
What you get
Up to 100% off emergency and medically necessary hospital care after review of your family's finances. Open now.
- Who starts it
- You
- How it’s sent
- Fax to 816-302-9907
- Your time
- About 15 minutes
- Last checked
- Aug 27, 2026
Before you start, check you fit
- Household income must be at or below 300% of the Federal Poverty Guidelines.
- Other available programs, including Medicaid, must be used first.
- Out-of-network, elective, and non-medically necessary services are excluded.
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What their form asksA preview, so you can gather things first. Fill it in on their site.
Open the application PDF ↗ Checked Aug 27, 2026Fax it to 816-302-9907.
What the form asks for
Financial Assistance ApplicationTODAYS DATERESPONSIBLE PARTY: Last; First; MI; Home Address; City; State; Zip; Relationship to Patient(s); Primary Phone; Date of BirthPATIENT INFORMATION: Patient First Name; Patient Middle Name; Patient Last Name; Patient Date of BirthHousehold and income information requested by the applicationSignature of Patient/Parent/Legal Guardian; Relationship; DateHave ready
- Completed and signed Financial Assistance Application or completed MyChart application.
- Proof of Kansas or Missouri residency.
- Recent paycheck stubs.
- Recent income tax return.
After you send
For questions, call 816-234-3567. If denied, use the instructions in the written appeal or additional-review letter. If you have not heard back in two weeks, write and ask whether it arrived.