How do you write a hardship letter for medical expenses?

Subject: Request for Financial Hardship Consideration – Medical Expenses

Dear [Recipient's Name],

I hope this letter finds you well. I am writing to request your kind consideration in addressing a challenging situation I am facing regarding my medical expenses. My name is [Your Name], and I am a patient receiving care from your esteemed healthcare facility.

I have been experiencing significant financial hardships due to an unexpected medical condition that requires ongoing and costly treatment. The medical bills have accumulated to a substantial amount, and despite my best efforts, I am unable to meet the financial obligations on my own.

I humbly request your assistance in reviewing my case and considering a financial hardship program or any support that may be available to alleviate the burden of these medical expenses. Hereby, I am providing relevant details:

Patient Information:

- Full Name: [Your Name]

- Patient ID/Medical Record Number: [Your Medical Record Number]

Medical Condition:

- Diagnosis: [Provide the medical diagnosis or condition]

- Treatment: [Briefly explain the required treatment, medications, or procedures]

- Duration: [Specify the duration of the treatment]

Financial Hardship Details:

- Total Medical Bills: [Provide the total amount of unpaid medical bills]

- Sources of Income: [Outline your current income sources, including employment, Social Security, or any other sources]

- Monthly Expenses: [List down your essential monthly expenses, such as rent/mortgage, utilities, food, transportation, etc.]

- Savings: [Mention any savings or assets available to cover the expenses]

Supporting Documentation:

- Attached to this letter, please find copies of:

- Medical bills

- Proof of income (e.g., pay stubs, recent tax return)

- Bank statements (reflecting current financial status)

I kindly request your prompt attention to this matter, as the financial strain has adversely affected my well-being and ability to manage my medical treatments effectively. I would be grateful for the opportunity to discuss my situation in more detail and possibly arrange a meeting to explore options for resolving the financial burden.

I understand that these decisions may involve careful considerations and guidelines. However, I firmly believe that your institution stands for compassion and patient welfare, and I am hopeful that you will consider my appeal with empathy.

Thank you for your understanding and support. I look forward to hearing from you soon.

Yours sincerely,

[Your Name]

[Your Contact Information (phone number, email)]