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Patient Assistance
Program

Patient Financial Assistance Program

InfuSystem offers financial assistance to individuals who meet our eligibility requirements. Patients may be required to apply for financial assistance by completing our Financial Assistance Application. We will also honor any uninsured or financial assistance discount that your healthcare provider offers. We require a copy of the award or approval letter to apply the discount.

Patient Financial Assistance Application

Please ensure to complete all required information to the best of your ability. This information is confidential and is only used for the purpose of determining your discount.

If you do not meet the income guidelines for the assistance program but are having difficulty paying your entire balance you may be eligible for a payment plan.

Mail Completed Application to:

InfuSystem
Patient Services
3851 W. Hamlin Rd.
Rochester Hills, MI 48309

PATIENT FINANCIAL ASSISTANCE APPLICATION

For more information contact our Patient Services Department at 1-833-570-4737. We are available to assist you Monday-Friday from 8am-5pm ET.

External Payment Portal Notice
By selecting “Continue,” you will be redirected to InstaMed’s payment portal to complete your transaction. You are leaving the InfuSystem website. InstaMed may place tracking and marketing cookies or tags on your device while you use its site. These technologies are implemented by InstaMed and are not used or controlled by InfuSystem. We encourage you to review InstaMed’s privacy policy to understand how such cookies and tags are used and how your information may be processed. If you do not wish to proceed to the external payment portal, please cancel and return to the InfuSystem website.

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External Payment Portal Notice
By selecting “Continue,” you will be redirected to InstaMed’s payment portal to complete your transaction. You are leaving the InfuSystem website. InstaMed may place tracking and marketing cookies or tags on your device while you use its site. These technologies are implemented by InstaMed and are not used or controlled by InfuSystem. We encourage you to review InstaMed’s privacy policy to understand how such cookies and tags are used and how your information may be processed. If you do not wish to proceed to the external payment portal, please cancel and return to the InfuSystem website.

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