Patients & Visitors

Need Financial Assistance?

Inova offers financial assistance to patients who need help with their medical bill. There are several ways you can apply for financial assistance through Inova:

Apply in Inova MyChart

  • You can apply directly in Inova's MyChart portal. Sign up or login to MyChart to complete your application (Login, click Menu, then scroll down to Financial Assistance under Billing).
  • You can also submit required documentation, monitor the status, and check eligibility.

Apply by Mail

  • You can submit your application for financial assistance via mail
  • Please note that this is mailing address only and is not available for patient walk-ins

Once complete, send your application to the following address:

Inova Patient Financial Services
8095 Innovation Park Dr.
Fairfax VA 22042
Fax Number: 571-665-6895

Apply in Person

You can submit or drop off your application in person at the following address:

Inova Partnership for Healthier Communities
2700 Prosperity Ave., #280
Fairfax VA 22031

  • Hours of operation: Monday – Friday, 8:30 a.m. – 12:00 p.m.
  • Additional services offered include questions about your application, required documentation, and notary service for required forms.

Talk to Inova's Financial Assistance Team

  • Call Inova's Financial Assistance Team at 571-472-5880
  • Hours of operation: Monday – Friday, 8:00 a.m. – 4:30 p.m.

Download Financial Assistance Applications

Financial Assistance Policies and Documentation

English

Full policy
Plain language summary
• Appendix A: Federal Poverty Guidelines
• Appendix B: Covered List
• Appendix C: Required Documentation Checklist
• Letter of Circumstances
• Verification of Employment
• Verification of Support
• Verification of Self-Declaration
• Verification of Residency

Amharic

Full policy
Plain language summary
• Appendix A: Federal Poverty Guidelines
• Appendix B: Covered List
• Appendix C: Required Documentation Checklist
• Letter of Circumstances
• Verification of Employment
• Verification of Support
• Verification of Self-Declaration
• Verification of Residency

 

Arabic

Full policy
Plain language summary
• Appendix A: Federal Poverty Guidelines
• Appendix B: Covered List
• Appendix C: Required Documentation Checklist
• Letter of Circumstances
• Verification of Employment
• Verification of Support
• Verification of Self-Declaration
• Verification of Residency

Dari

Full policy
Plain language summary
• Appendix A: Federal Poverty Guidelines
• Appendix B: Covered List
• Appendix C: Required Documentation Checklist
• Letter of Circumstances
• Verification of Employment
• Verification of Support
• Verification of Self-Declaration
• Verification of Residency

Farsi

Full policy
Plain language summary
• Appendix A: Federal Poverty Guidelines
• Appendix B: Covered List
• Appendix C: Required Documentation Checklist
• Letter of Circumstances
• Verification of Employment
• Verification of Support
• Verification of Self-Declaration
• Verification of Residency

Korean

Full policy
Plain language summary
• Appendix A: Federal Poverty Guidelines
• Appendix B: Covered List
• Appendix C: Required Documentation Checklist
• Letter of Circumstances
• Verification of Employment
• Verification of Support
• Verification of Self-Declaration
• Verification of Residency

Mandarin Chinese

Full policy
Plain language summary
• Appendix A: Federal Poverty Guidelines
• Appendix B: Covered List
• Appendix C: Required Documentation Checklist
• Letter of Circumstances
• Verification of Employment
• Verification of Support
• Verification of Self-Declaration
• Verification of Residency

Spanish

Full policy
Plain language summary
• Appendix A: Federal Poverty Guidelines
• Appendix B: Covered List
• Appendix C: Required Documentation Checklist
• Letter of Circumstances
• Verification of Employment
• Verification of Support
• Verification of Self-Declaration
• Verification of Residency

Urdu

Full policy
Plain language summary
• Appendix A: Federal Poverty Guidelines
• Appendix B: Covered List
• Appendix C: Required Documentation Checklist
• Letter of Circumstances
• Verification of Employment
• Verification of Support
• Verification of Self-Declaration
• Verification of Residency

Vietnamese

Full policy
Plain language summary
• Appendix A: Federal Poverty Guidelines
• Appendix B: Covered List
• Appendix C: Required Documentation Checklist
• Letter of Circumstances
• Verification of Employment
• Verification of Support
• Verification of Self-Declaration
• Verification of Residency