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  • Paying your bill
  • Financial assistance
  • Insurance
  • Medical records
  • Hospital price estimates
  • Patient portal

Financial assistance for UT, ID and NV

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Apply online

If you need help paying for medical care at an Intermountain Health location, you should apply for financial assistance. You can apply online in English and Spanish

Apply in EnglishApply in Spanish
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Mail in your application

You may also print the application form, fill it out, and give the form, along with the appropriate documentation, to an Eligibility Counselor at an Intermountain facility.

Download English ApplicationDownload Spanish Application
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Talk to a financial counselor

Do you need help paying your bill? Our financial counselors can see if you qualify for financial assistance or discounts, help you make a payment plan or discuss your other options

(866) 415-6556

Our financial assistance policy

The documents below are available in eight languages. They will help you understand the process, file an application and learn about our financial assistance policy.

English 

Read our full policy about financial assistance.

Español (Spanish) 

Lea en su totalidad nuestra política sobre ayuda financiera.

العربية (Arabic) 

إقرأ بوليصتنا الكاملة حول المساعدة المالية.

汉语/漢語 (Chinese)

阅读了解有关我们财务援助的完整政策.

Le français (French)

Lisez toute notre politique sur l’assistance financière.

한국어/조선말 (Korean)

재정 보조에 관한 저희의 정책을 자세히 읽어 보시기 바랍니다.

Pу́сский (Russian)

Также ознакомьтесь с нашими правилами о предоставлении финансовой помощи. 

Tiếng Việt (Vietnamese)

Đọc toàn bộ chính sách về hỗ trợ tài chính của chúng tôi.