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Financial Assistance Application Checklist

Application Checklist

If you fail to provide the requested information your application will be deferred for 30 days. If you do not respond in 30 days, your application will be denied. Please make sure you sign and date the application.

How Do I Submit My Application?

Attn: Financial Counselor
Mount Desert Island Hospital
PO Box 8, Bar Harbor, ME 04609

Email: financialcounselor@mdihospital.org

Have You Applied for Insurance on the Health Insurance Marketplace?

If you have applied for insurance on the Health Insurance Marketplace (coverme.gov), you will be asked to provide information regarding coverage, if not, you may be asked to complete a Marketplace Application.

If you would like help completing a Marketplace Application, enrollment assistance is available.

Need Help?

If you have questions or need assistance completing the Financial Assistance Application, please call us at 207-288-5082 x 1202 or email Financialcounselor@mdihospital.org

Free Medical Care Income Guidelines

Free Care Guidelines

MDI Health has a Financial Assistance program for our patients. For more information please review our pamphlet on Free Care Cost Share. If you believe you may qualify for any of our Financial Assistance programs an application for Financial Assistance is required. Below is the 2026 Family Unit Size Income Guidelines

1……………………………………..$31,920

2……………………………………..$43,280

3…………………………………..…$54,640

4………………………………….….$66,000

5……………………………………..$77,360

6……………………………………..$88,720

7…………………………………..…$100,080

8………………………………….….$111,440

For family units with more than 8 members add $11,360 per additional member

MDI Hospital

MDI Hospital
10 Wayman Lane
Bar Harbor, ME 04609
207.288.5081

At Mount Desert Island Hospital, we provide comprehensive care for you and your family through our hospital in Bar Harbor and a network of health centers across Mount Desert Island.