Financial Assistance

North Kansas City Hospital serves all patients, including those who do not have health insurance coverage or who cannot pay for all or part of emergency or medically necessary services. Our Patient Accounts team can help you understand the billing and insurance process and apply for financial assistance, if you qualify.

Financial Assistance Applications and our Financial Assistance Policy are free. You can get copies of each in-person, online or by mail.

  • IN-PERSON: Obtain an application at any one of the check-in areas or in Account Services, 2nd Floor Hospital (via the Main entrance)
  • ONLINE: Download the application form below.
  • MAIL: Request an application be mailed to you by calling the Patient Accounts Department at 816.691.2040 or 866.691.2040 (toll-free).

Contact Us

To speak with a member of our Patient Accounts team, call 816.691.2040 or 866.691.2040 (toll-free), Monday-Friday, 8:30 a.m.- 5 p.m.

Financial Assistance Application Forms

NKCH Financial Assistance Application – ENGLISH
NKCH Financial Assistance Application – SPANISH
NKCH Financial Assistance Application – VIETNAMESE

Financial Assistance Information

NKCH Plain Language Summary – ENGLISH
NKCH Plain Language Summary – SPANISH
NKCH Plain Language Summary – VIETNAMESE

NKCH Financial Assistance Policy – ENGLISH
NKCH Financial Assistance Policy – SPANISH
NKCH Financial Assistance Policy – VIETNAMESE

NKCH Billing and Collections Policy – ENGLISH
NKCH Billing and Collections Policy – SPANISH
NKCH Billing and Collections Policy – VIETNAMESE

NKCH Amounts Generally Billed (AGB) Document – ENGLISH
NKCH Amounts Generally Billed (AGB) Document – SPANISH
NKCH Amounts Generally Billed (AGB) Document – VIETNAMESE


CarepaymentManage your medical expenses with our affordable financing option.