AMBULANCE BILLINGBeginning 1/23/2018, the City of Madison utilizes billing services from Andres Medical Billing. For more information, please visit:
Ambulance Hardship Waiver Information
The City of Madison Hardship Waiver (PDF) is designed to help people who have no insurance or the means to pay. Failure to completely and accurately provide the information required below may result in denial of the waiver.
HARDSHIP WAIVER REQUIREMENTS
If you would like to be considered for a waiver, ALL FOUR of the following steps must be completed and submitted to our office:
To apply for a hardship waiver online, please prepare the documentation listed below and visit https://madisonhardship.com. Please call 877-618-0943 if you have questions about the hardship waiver portal.
STEP 1: SIGNED STATEMENT
STEP 2: PROOF OF TOTAL FAMILY ANNUAL INCOME = A SIGNED COPY OF YOUR MOST RECENT FEDERAL INCOME TAX FORM, including social security (line 20a).
STEP 3: ARE YOU RECEIVING OR ELIGIBLE FOR GOVERNMENTAL ASSISTANCE
STEP 4: DO YOU HAVE PRIVATE HEALTH OR ACCIDENT INSURANCE?
Our Madison – Inclusive, Innovative, & Thriving
Copyright © 1995 - 2020 City of Madison, WI