Children’s Hospital of The King’s Daughters is committed to caring for all patients, birth to age 21, without regard to their financial situation.
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Do You Qualify?
CHKD cares for every child who needs our services, regardless of any family’s ability to pay. Depending on your income and family size, you may qualify for our financial assistance.
For more information about the program, please call (757) 668-7141 to speak confidentially to the health benefits analyst.
Applicants will be asked to provide documented proof of need including income tax records, pay stubs, family size and proof of residence.
To apply,
fill out this typeable PDF. Be sure to sign and date your application, then submit the completed application via mail, fax or email.
Children’s Hospital of The King’s Daughters Patient Financial Services – HBA
601 Children’s Lane
Norfolk, VA 23507
Phone: (757) 668-7141
Email: charitycare@chkd.org
Fax (757) 668-9181
Our health benefits analysts will let you know if discounted or free care is an option, based on the federal poverty guidelines for income and family size as illustrated in the chart below.
CHKD’s Guidelines for Financial Assistance*
Number of Adults and Children in Family | Percent Reduction of CHKD Charges Based on Income |
| | 100% | 75% | 50% | 25% |
| 1 | Income up to $21,857 | Income up to $31,224 | Income up to $40,592 | Income up to $49,960 |
| 2 | Income up to $29,529 | Income up to $42,274 | Income up to $54,957 | Income up to $67,640 |
| 3 | Income up to $37,327 | Income up to $53,324 | Income up to $69,322 | Income up to $85,320 |
| 4 | Income up to $45,062 | Income up to $64,374 | Income up to $83,687 | Income up to $103,000 |
| 5 | Income up to $52,797 | Income up to $75,424 | Income up to $98,052 | Income up to $120,680 |
| 6 | Income up to $60,532 | Income up to $86,474 | Income up to $112,417 | Income up to $138,360 |
| 7 | Income up to $68,267 | Income up to $97,524 | Income up to $126,782 | Income up to $156,040 |
| 8 | Income up to $76,002 | Income up to $108,574 | Income up to $141,147 | Income up to $173,720 |
*Chart uses 2019 federal poverty guidelines. For future poverty guidelines, visit
http://aspe.hhs.gov/poverty/.
Assets include, but are not limited to, primary residence, rental property, securities, bank deposits, business assets and investments.
¿Usted califica?
El Children’s Hospital of The King’s Daughters se preocupa por cada niño que necesita nuestros servicios, independientemente de la capacidad de cualquier familia que pagar. Dependiendo del tamaño de los ingresos y de la familia, usted puede calificar para nuestra ayuda financiera.
Para obtener más información sobre el programa, por favor llame al (757) 668-7141 para hablar confidencialmente con el analista de beneficios para la salud.
Se les pedirá a los solicitantes que presenten una prueba documentada de necesidad incluyendo los registros de impuestos, recibos de pago , tamaño de la familia y prueba de residencia.
Para solicitar,
llene este tipificable PDF. Asegúrese de firmar y fechar su solicitud , a continuación, enviar la solicitud completa por correo, fax o correo electrónico.
Children’s Hospital of The King’s Daughters Patient Financial Services – HBA
601 Children’s Lane
Norfolk , VA 23507
Teléfono: 757.668.7141
E-mail: charitycare@chkd.org
FAX : 757.668.9181
Instrucciones
para Asistencia Financiera en el CHKD
| Número
de Adultos y Niños en la Familia | Porcentage de Reducción de Cargos del CHKD Basado en Ingresos |
| | 100% | 75% | 50% | 25% |
| 1 | Ingreso hasta $21,857 | Ingreso hasta $31,224 | Ingreso hasta $40,592 | Ingreso hasta $49,960 |
| 2 | Ingreso hasta $29,592 | Ingreso hasta $42,274 | Ingreso hasta $54,957 | Ingreso hasta $67,640 |
| 3 | Ingreso hasta 37,327 | Ingreso hasta $53,324 | Ingreso hasta $69,322 | Ingreso hasta $85,320 |
| 4 | Ingreso hasta $45,062 | Ingreso hasta $64,374 | Ingreso hasta $83,687 | Ingreso hasta $103,000 |
| 5 | Ingreso hasta $52,797 | Ingreso hasta $75,424 | Ingreso hasta $98,052 | Ingreso hasta $120,680 |
| 6 | Ingreso hasta $60,532 | Ingreso hasta $86,474 | Ingreso hasta $112,417 | Ingreso hasta $138,360 |
| 7 | Ingreso hasta $68,267 | Ingreso hasta $97,524 | Ingreso hasta $126,782 | Ingreso hasta $156,040 |
| 8 | Ingreso hasta $76,002 | Ingreso hasta $108,574 | Ingreso hasta $141,147 | Ingreso hasta $173,720 |
*La tabla utiliza las recomendaciones de pobreza federal del 2019.
Para recomendaciones futuras, visite
http://aspe.hhs.gov/poverty/.
Los bienes/activos incluyen, pero no se limitan a, la residencia primaria, propiedades de renta, seguridades, depósitos bancarios, bienes de negocios e inversiones.