Broadlawns Community Care: Getting Help With a Des Moines Hospital Bill
Broadlawns Medical Center is Polk County's public hospital, and its Community Care Program is built for the people who live there. If your household income is modest, the policy can wipe out the bill for care at Broadlawns. If one stretch of treatment costs more than a tenth of your yearly income, a separate catastrophic rule can cap what you owe. Here's what the hospital's own documents say, including the places where they disagree.
AT A GLANCE
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Two programs under one policy
Broadlawns runs its assistance under Policy A-1006, the "Broadlawns Community Care Program and Catastrophic Financial Assistance" policy. The policy covers medically necessary care and emergency care. It defines emergency care the way the federal EMTALA law does, and that definition also includes a pregnant woman who is having contractions.
The two parts work differently:
Community Care is income-based. If your household earns little enough, it covers care and some prescriptions at Broadlawns.
Catastrophic Financial Assistance is for patients who don't qualify for Community Care but who face a very large bill compared with their income.
According to the plain-language summary, the program covers hospital, clinic, urgent care and emergency care at Broadlawns. It also covers a limited supply of prescriptions written by Broadlawns providers, some medical equipment provided by Broadlawns, and eyeglasses. It doesn't cover care you get somewhere else unless that care is approved, and it doesn't cover services that aren't medically necessary. The policy states the limit plainly: benefits are provided only at Broadlawns Medical Center, and it doesn't pay other hospitals, pharmacies or professionals unless another section of the policy allows it.
Broadlawns Medical Center provides emergency and medically necessary care to all patients, regardless of their ability to pay. (Broadlawns plain-language summary)
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The income tiers
The policy compares your household's gross income to the federal poverty income guidelines (FPIG) that HHS updates each year:
Household income | What the policy provides |
|---|---|
At or below 300% of FPIG | Full charity care (100%) |
301% to 400% of FPIG | Discount down to the amount generally billed (AGB) |
Above 400% of FPIG | Not eligible for Community Care; the catastrophic rule may still help |
The AGB is the average share of gross charges that Medicare, Medicaid and private insurers actually paid Broadlawns. The policy's Attachment A puts that share at 41.3%, based on calendar year 2018 claims. So in the middle tier, your bill is limited to roughly what an insured patient's plan would have paid. The policy says the AGB percentage is supposed to be updated every year, so ask Financial Counseling which figure it uses now.
The posted dollar chart
The billing page links to an income chart titled "Broadlawns Medical Center 2025 Federal Guideline for Community Cares." Here are the yearly figures from two of its columns. Broadlawns labels the first one "302% State/County."
Household size | 100% of poverty | "302%" column | 400% column |
|---|---|---|---|
1 | $15,650 | $47,263 | $62,600 |
2 | $21,150 | $63,873 | $84,600 |
3 | $26,650 | $80,483 | $106,600 |
4 | $32,150 | $97,093 | $128,600 |
5 | $37,650 | $113,703 | $150,600 |
6 | $43,150 | $130,313 | $172,600 |
The chart runs up to a household of 14, and it also lists monthly amounts. It uses the 2025 guidelines. When this guide was checked, Broadlawns hadn't posted a 2026 version.
The documents don't agree on the top income limit. Policy A-1006, last reviewed in June 2019, stops at 400% of poverty. The newer plain-language summary says that if your income is "at or below 600% of the FPIG, you may qualify for partial or full financial assistance." If your household falls between those two numbers, apply anyway and ask a financial counselor which limit Broadlawns is using.
How Broadlawns counts income and household
Gross income, counted the way Iowa Medicaid counts it.
Who's included: for an adult, the patient and their spouse. For a minor, the patient, the patient's mother and the patient's father. Income from legally responsible people outside the home counts too.
What counts as income: wages, disability, retirement or pension, rental income, unemployment, VA benefits, child support, alimony, interest, dividends, workers' compensation, oil and gas royalties, and "support-in-kind," such as housing someone gives you for free.
What doesn't: food stamps (SNAP) aren't counted.
Assets: resource limits follow Iowa Medicaid's rules.
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The catastrophic rule
This part of the policy is for people whose income is too high for Community Care, or who don't qualify for another reason. The rule is short:
If your total charges over a 90-day period are more than 10% of your family's gross annual income, your balance may be reduced to that 10%.
The rest can go on a payment plan set up through Financial Counseling.
If your family has more than $10,000 in liquid assets, you don't qualify, and you owe the full balance.
Here's an example (our own math, not a Broadlawns figure). Say a family of three earns $120,000 a year, which is above the 400% line on the chart. Over 90 days they run up $30,000 in Broadlawns charges. Ten percent of their income is $12,000. The rule lets Broadlawns cut the balance to $12,000, and the $12,000 could then go on a payment plan. The policy says "may be reduced," so this is something you apply for, not a guaranteed cap.
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Rules that trip people up
Other coverage comes first. The program pays only after every other source has paid. If you qualify for Medicaid, Medicare, job-based insurance or a Marketplace plan, the summary says you must apply for it and keep it active.
Marketplace timing. Uninsured patients between 133% and 400% of poverty who missed the Marketplace enrollment deadline can still qualify. But they must enroll in the next enrollment period or risk losing eligibility. If you lost Marketplace coverage because you didn't pay premiums, you aren't eligible.
Children. Patients under 19 must apply for Medicaid (Title XIX) or Hawk-I first. If you refuse to pay Hawk-I premiums, that refusal can't be the reason you qualify for Community Care.
Insured patients. If you have insurance and meet the financial requirements, the policy says your deductibles and coinsurance can be reduced. Broadlawns may also waive or reduce Medicare and Medicaid cost-sharing based on financial need, but only for patients who ask and apply.
Prompt-pay discounts. Assistance under A-1006 doesn't stack with the separate self-pay discount for prompt payment (Policy A-1015).
Honesty. If any information turns out to be false, assistance can be withdrawn, including for past care.
When you may skip the full application
The policy allows presumptive eligibility, which means approval without the complete application, if records show the patient:
gets food stamps, WIC or subsidized school lunch
qualifies for another state or local assistance program
is homeless or received care from a homeless shelter or free clinic
has died with no known estate
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What to bring
The application's checklist and the billing page ask for slightly different proof. This table combines the two lists:
Item | What Broadlawns asks for |
|---|---|
Photo ID | A valid Iowa state ID or Iowa driver's license (application); the billing page also accepts other state-issued photo ID |
Social Security number | Your card, or a tax return, W-2 or other document that shows the number |
Proof you live in Polk County | Rent receipts, utility bills, insurance statements or official mail sent to your living address in the last 30 days. A PO box, junk mail and mail from Broadlawns don't count |
Household income | All income from the last 90 days for everyone in the household: pay stubs, employer letter, Social Security or disability award letters, child support, workers' comp. If you're self-employed, an expense ledger and your latest tax return. If you're unemployed, a "White Sheet" from Iowa Workforce Development |
Accounts | Statements from the past 90 days for checking, savings, IRAs, 401(k)s, CDs, stocks, bonds, trusts, annuities, IPERS and similar accounts |
Insurance | Medicare, Medicaid, VA and other insurance cards for everyone in the household |
Other | The billing page also lists a state-issued birth certificate for each eligible person and your most recent federal tax return |
If you truly can't get income documents, the policy lets you sign an attestation, which is a signed statement that the income on your application is true. You'll need to explain why the documents aren't available.
APPLY FOR THE BROADLAWNS COMMUNITY CARE PROGRAM
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After you apply
Step | What the documents say |
|---|---|
While income is being checked | You may be treated as a private-pay patient in the meantime |
Prescriptions while you wait | Clinic patients with a pending first application may use the Broadlawns pharmacy for up to 15 days |
Decision | You'll get a written approval or denial. A denial includes the reasons |
Appeal | Write to the Supervisor of Financial Counseling within 10 days of the denial date |
How long approval lasts | Up to 12 months. You can extend it with updated information |
Changes | Report changes in household income or insurance within 10 business days |
Once you're approved, there are a few limits on prescriptions. Each fill is capped at a 30-day supply and can't run past your eligibility end date. The drug must be on the program's formulary (its list of covered drugs), and an approved program provider must write the prescription. Uninsured Polk County inpatients whose Iowa Health and Wellness or Marketplace coverage is still pending can get a 10-day supply.
If the bill has gone to collections
Broadlawns' Billing and Collections policy follows the federal rules for nonprofit hospitals. Here are the parts that protect you:
Application window: you can apply until at least 240 days after the first bill you receive after leaving the hospital.
Notice first: before any "extraordinary collection action," such as a lawsuit, a lien on your home or garnished wages, Broadlawns must send written notice. That notice includes the plain-language summary and a deadline at least 30 days away.
A 100-day pause: while your eligibility hasn't been decided, Broadlawns won't start those actions for 100 days after your first post-discharge bill. Any extra deadline in the notice adds to that time.
Applying stops collections: a complete application filed within the window suspends collection actions until Broadlawns decides. If you qualify, it must reverse actions already taken. An incomplete application also pauses them while you finish it.
Medicaid first: if Broadlawns thinks you may qualify for Medicaid, it can wait for the Medicaid decision before deciding on assistance.
Protected property: assets that state or federal law protects from collection are off-limits.
Accident settlements: a hospital lien on an accident settlement isn't treated as an extraordinary collection action.
For Medicaid questions, call Iowa Medicaid at 1-855-889-7985. Broadlawns' counselors can also help you apply or reapply.
Related guides
Official sources
Last checked: October 30, 2026. Facts come from Broadlawns' Billing & Financial Services page, Policy A-1006 (last reviewed June 2019) and its Attachment A, the Billing and Collections policy, the plain-language summary, the application, and the 2025 income chart. The catastrophic-rule example is our own math.
This is general information, not legal or financial advice. Broadlawns decides who qualifies. Before you rely on these numbers, confirm the current income limits and AGB rate with Financial Counseling.
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