2811 Tieton Drive,
Yakima, WA 98902 Map this address

(509) 575-8000

Financial Assistance Application Form Instructions

Below is an application for financial assistance (also known as charity care) at Virginia Mason Memorial.

Washington State requires all hospitals to provide financial assistance to people and families who meet certain income requirements. You may qualify for free care or reduced-price care based on your family size and income, even if you have health insurance.

What does financial assistance cover? The hospital financial assistance covers appropriate hospital-based services provided by Virginia Mason Memorial depending upon your eligibility. Financial assistance may not cover all health care costs, including services provided by other organizations.

If you have questions or need help completing this application: Memorial's Business Office at (509) 575-8255.

You may obtain help for any reason, including disability and language assistance.

In order for your application to be processed, you must:

  • Provide us information about your family
    Fill in the number of family members in your household (family includes people related by birth, marriage, or adoption who live together)
  • Provide us information about your family's gross monthly income (income before taxes and deductions)
  • Provide documentation for family income and declare assets
  • Attach additional information if needed
  • Sign and date the form

Note: You do not have to provide a Social Security number to apply for financial assistance. If you provide us with your Social Security number it will help speed up processing of your application. Social Security numbers are used to verify information provided to us. If you do not have a Social Security number, please mark "not applicable" or "NA."

Mail or fax completed application with all documentation to:

Memorial Business Services, 3803 W. Nob Hill Blvd., Yakima, WA 98902 Be sure to keep a copy for yourself.

To submit your completed application in person:

Memorial Business Services, 3803 W. Nob Hill Blvd., Yakima, WA 98902

We will notify you of the final determination of eligibility and appeal rights, if applicable, within 14 calendar days of receiving a complete financial assistance application, including documentation of income.

By submitting a financial assistance application, you give your consent for us to make necessary inquiries to confirm financial obligations and information.

We want to help. Please submit your application promptly! You may receive bills until we receive your information.

NEW! Telehealth: Let us bring your Healthcare to you.

We are now offering Telehealth visits at all Virginia Mason Memorial clinics. These are typical appointments with your provider but from your home, work, or wherever is most convenient for you

Learn more about joining one of our providers for a Telehealth visit »

COVID-19 Evaluation Clinic: Our Creekside HealthyNow location is now a COVID-19 evaluation clinic. If you have cough and fever, please schedule your visit at our Creekside Location. Please list your symptoms in the reason for visit so our team is better prepared to assist you.

This location completes an evaluation to determine if you're a candidate for COVID testing. Learn more »

COVID-19 Virginia Mason Memorial Press Conference March 21

Hospital Visitor Restrictions

Visitor Restrictions Poster

Latest News

Physician Recruitment: Our Physician and Provider recruiting efforts have been modified in the wake of the COVID-19 pandemic. At present, we are scheduling phone calls with interested candidates, but site visits are not allowed. Also, we will not be extending contracts during the acute phase of the COVID-19 response. Please know how much we appreciate your interest in us and how much we hope to have the opportunity to consider you further for a role with VMM.

Please contact us at physicianrecruitment@yvmh.org to schedule a phone call with one of our recruiters.

Additional Spiritual Resources During COVID-19

For prayers and spiritual care requests please email CurtisMcFarland@yvmh.org

Tele-Chaplaincy

There are times when a direct face to face spiritual care conversation is not the best option (due to distance, a pandemic, patient preference). That's where Tele-Chaplaincy provides another possibility. You can request chaplain support using your personal or hospital room phone to connect confidentially with a hospital chaplain. Chaplains will listen, provide encouragement, offer help and resources, if you are part of a faith community the chaplain can help you connect with them, and, if desired, the chaplain can provide prayer.

Virtual Chaplaincy

There are times when a direct face to face spiritual care conversation is not the best option (due to distance, a pandemic, patient preference). That's where Tele-Chaplaincy provides another possibility. You can request chaplain support using your personal or hospital room phone to connect confidentially with a hospital chaplain. Chaplains will listen, provide encouragement, offer help and resources, if you are part of a faith community the chaplain can help you connect with them, and, if desired, the chaplain can provide prayer.

Elective surgeries: Based on directives from the Centers for Disease Control and Prevention Virginia Mason Memorial is postponing elective surgeries and procedures.

Visitors to the Family Birthplace: In another protective measure, the hospital is also further limiting visitors to the Family Birth Place. Women in labor may have two visitors until the baby arrives. After the birth there may be only one visitor.

Hospital Lab Services: All out-patient lab services - including newborn screens and bilirubin collections - will now be provided at Memorial Cornerstone Medicine, 4003 Creekside Loop. Hours are 7 a.m. to 6 p.m. Monday through Friday; 8 a.m. to noon, Saturday and Sunday.

Hospital pharmacy: Beginning Thursday, March 19, the hospital pharmacy is closed to the public for the duration of the pandemic. The public may choose to have those prescriptions transferred to VMM's Pharmacy at Creekside or the pharmacy of their choice. The Pharmacy at Creekside, 4003 Creekside Loop, is open 8:30 a.m. to 6 p.m. Monday through Friday; and Saturday and Sunday 8 a.m. to 4:30 p.m. and offers walk-in or drive-through options for pickup.

Farmacia del Hospital: A partir del jueves 19 de marzo, la farmacia del hospital estará cerrada al público mientras dure la pandemia. El público puede escoger si quiere que sus recetas sean transferidas a la otra farmacia de Virginia Mason Memorial, localizada en la clínica Cornerstone o también puede elegir cualquier otra farmacia de su preferencia. La clínica de Cornerstone, está localizada en el 4003 Creekside Loop. En esta farmacia se puede recoger la medicina por la ventana y/o adentro de la clínica.

Horario: Lunes a Viernes de 8:30 a.m. a 6:00 p.m. y sábado y domingo de las 8:00 a.m. a las 4:30 pm