To write a letter requesting help with hospital bills, start with a polite greeting and introduce yourself, mentioning your situation briefly. The document provides two sample request letters asking for financial assistance to pay hospital bills.Ask for a copy of the policy. Some payers may require that the prescriber documents a patient's medical necessity for treatment to get insurance coverage for a pharmaceutical product. Copy and paste our template letter and fill in your details. You can ask your doctor if they have any articles from medical journals. Ask your insurance company for an appeal form or write out your appeal. Mail this application to Massachusetts Department of Revenue,. PO Box 7021, Boston, MA 02204 Attn: Hardship or fax to 617-. 660-3995.