Get ready to apply
Nationwide Children's Hospital
Nationwide Children's Hospital Financial Assistance Program
What you get
Help with basic medically necessary hospital care and medically necessary balances not covered by medicaid when program requirements are met. Open now.
- Who starts it
- You
- How it’s sent
- Email to Children'sPatientAccounts@NationwideChildrens.org
- Your time
- About 30 minutes
- Last checked
- Aug 27, 2026
Before you start, check you fit
- Your child is 18 or under.
- Applicants must pursue other available resources first.
- The current public summary does not state the exact discount percentage for each income band up to 400% FPL.
-
What their form asksA preview, so you can gather things first. Fill it in on their site.
Open the application PDF ↗ Checked Aug 27, 2026Send it by email to Children'sPatientAccounts@NationwideChildrens.org.
What the form asks for
HCAP and Financial Assistance ApplicationPatient NameGuarantor NameAddress, City and StatePhone NumberPlace Registration Sticker Here OR Date of ServiceWas the patient living in Ohio at the time of serviceWas the patient a citizen of the United States at the time of serviceDid the patient have Medical Insurance at the time of serviceWas the patient an active Medicaid recipient at the time of serviceWas the patient an active recipient of Disability Assistance at the time of serviceFamily Member's NameAgeDate of BirthRelationship To PatientSource of Income or Employer NameIncome for 3 months prior to date of serviceIncome for 12 months prior to date of serviceIncome verification attachedIf you reported $0 income, please provide a brief explanation of how you (or the patient) are surviving financiallyApplicant's signatureDateHave ready
- A separate completed and signed application for each patient.
- Copies of pay stubs or a letter from the employer; the form also allows the applicant to check Unable to Provide. The policy reserves the right to request pay checks, W-2s, and income tax returns.
After you send
Call 614-722-2055 for application help or to ask about missing information. Respond to any written incomplete-application notice with the requested facts or documents. If you have not heard back in two weeks, write and ask whether it arrived.