Parkland Self-Pay Charity Discount Program

Parkland offers a discount program for self-pay patients who do not qualify for another funding source. This program offers a discount to help pay for medically necessary services. The Self-Pay Charity Discount Program is not health insurance. Self-Pay Charity Discount Program is financial help for medical services received at a Parkland location.

Who Can Qualify?

The Self-Pay Charity Discount Program is for self-pay patients who do not qualify for another funding source. The level of discount is based on the Federal Poverty Income Level, Dallas County residency status and type of healthcare services provided.

In order to qualify, you must:

• Undergo a financial screening to determine eligibility
• Provide documents that show eligibility
• Apply for all other programs you may be eligible for
• Agree to make good faith payments at the time of service based on your ability to pay

You can read the full Self-Pay Charity Discount Policy or Self-Pay Charity Discount Policy (Spanish).

What Is Covered Under This Program

Under the discount program, medically necessary healthcare services are provided by Parkland without charge or at a discount to qualifying patients. Services eligible for the discount program include:

• Emergency medical services provided in the emergency room
• Services provided in response to life-threatening circumstances
• Services for a condition which, if not promptly treated, would lead to an adverse change in the health status of a person
• Primary and preventive services and medical screenings
• Immunizations for flu and pneumonia
• Annual physical examinations
• Mammograms and pap smears every two years unless ordered more frequently
• Inpatient and outpatient hospital services provided at Parkland or at a facility with which Parkland has contracted
• Radiology and lab services at Parkland or a facility with which Parkland has contracted

How To Apply

Follow the instructions below to apply for the Self-Pay Charity Discount Program in four simple steps.

1. Complete the application, click to view and download. (English | Spanish)

2. Gather the documents needed. Parkland requires proof of:

• That you live in Dallas County (residency)
• Valid photo identification (ID)
• Income
• Number of people in your household

3. Review the complete list of documents.

4. Return the completed application and copies of all documents. You can return the form and proof in any of the following ways:

• Submit By Mail

  Address

  Patient Financial Services
  5200 Harry Hines Blvd.
  Dallas, TX 75235

• Submit Online

  Go to Parkland MyChart. Don't forget to attach application and proof of income.

• Submit In Person

  Bring your renewal form and proof of income to a financial counselor Monday through Friday, 8 a.m. - 4 p.m. Counselors are conveniently located at Parkland clinics throughout Dallas County.

Applying for the program does not guarantee approval. The Self-Pay Charity Discount Program is not health insurance. If you qualify for coverage through your employer or the Health Insurance Marketplace, you will need to enroll during those open enrollment periods.

How Much Does It Cost?

There is no cost to enroll or complete a financial screening.

This program offers a discount to help pay for medically necessary services. The level of discount is based on the Federal Poverty Income Level, Dallas County residency status and type of visit (emergency or non-emergency care). The discount ranges from 65 to 90 percent. There is a limit for how much you must pay for emergency services.

Contact Patient Financial Services

214-590-8831
Monday – Friday
8 a.m. – 4:30 p.m.

Parkland Tower Garage
2021 Medical District Drive
Dallas, TX 75235

Parkland provides translation services in 166 different languages.