Financial Assistance Policy

Español   বাঙালি   ગુજરાતી   Tiếng Việt   中文

AtlantiCare Regional Medical Center's (ARMC) Financial Assistance Policy (FAP) exists to provide eligible patients partially or fully-discounted emergency or other medically necessary healthcare services provided by ARMC (as defined by the IRS). Patients seeking financial assistance must complete and submit an application form.

Please use the link below to download, print, and complete your application. Bring your completed application to one of our three locations during the hours designated below.

Understanding ARMC's Financial Assistance Policy

Plain Language Summary (Overview)

Financial Assistance Application Form

Financial Assistance Policy

Billing and Collections Policy

Charity Care Forms

Charity Care/Financial Services

Related Resources

ARMC's Payor Contract Agreements 2017

Charity Care Application


Locations & Directions

Printable Campus Maps

Effective January 1st, 2014 The Charity Care program is designed to help those individuals that are not eligible for the insurances offered through the Health Insurance Marketplace or have a balance after their insurance has paid.

Eligibility is based upon your income and assets on your day of service. The program does not cover physician fees. The documents listed below (with some examples) may be requested to complete your Charity Care Application:

  • Identification: For example, Driver’s License or Passport or Birth Certificate or Social Security Card for each member of the family.
  • Proof of NJ Residency (prior to date of service): NJ Driver’s License or utility bill or copy of lease or deed or support letter.
  • Documentation of income: Pay stubs or letter from the employer on letterhead that provides a breakdown of your gross salary either 4 weeks 13 weeks or 52 weeks prior to the date of service. Social Security benefit letter or Welfare (Package “G”) benefit letter (covering the date of service). If no income was earned then a support letter should be included with the application.
  • Documentation of Assets: Checking and Savings accounts, IRA’s, Stocks, Bonds and certificate of deposits are all examples of the type of balances that are to be provided as of the date of service on your Charity Care application.

To apply for the Charity Care Program, download and complete the following form.

Your completed application should be mailed or delivered to one of the following locations:

Back to Top


AtlantiCare HealthPlex

1401 Atlantic Avenue
Atlantic City, NJ 08401

In-Person Drop off
Monday thru Friday
7:30 AM – 4:30 PM
1st Floor – Outpatient Registration
Office #1356

AtlantiCare Regional Medical Center

65 W. Jimmie Leeds Road
Pomona, NJ 08240

In-person Drop off
Monday thru Friday
8:00 AM – 5:00 PM
Saturday – By Appointment Only
Call: (609) 748-4042
Report to Hospital Lobby Information Desk for Pass

AtlantiCare Health Park at Hammonton

219 N. White Horse Pike
Hammonton, NJ 08037

In-person Drop off
Wednesdays Only
8:00 AM – 4:00 PM

Back to Top

Related Resources

Back to Top


If you have questions about Charity Care, please call (609) 272-2500.

Back to Top

© Copyright AtlantiCare 2016. All Rights Reserved.