The document provides two sample request letters asking for financial assistance to pay hospital bills. To write a letter requesting help with hospital bills, start with a polite greeting and introduce yourself, mentioning your situation briefly.Draft a letter explaining your financial circumstances and why you can't afford to pay the bill. What do I include with my application? Utah Code 81-6-208 contains provisions regarding medical support in a Utah order. The cost of insurance premiums is a separate "add-on" obligation. What If I Can't Pay My Bill? A Medical Assistance Letter is a formal request for financial aid or support to cover medical expenses. Utah Code 81-6-208 contains provisions regarding medical support in a Utah order. Medicare may pay you directly when you complete this form and attach an itemized bill from your doctor or supplier.