Catholic Health Hospital Financial Assistance Policy: Plain Language Summary

The Catholic Health Hospital Financial Assistance Policy (Policy) applies to hospital services provided at a System Hospital for emergency or other medically necessary care. You will not be denied medically necessary hospital services based on your inability to pay, unpaid medical bills or immigration status. It does not include physician and other provider services provided at a System Hospital. Additionally, dental, occupational, physical and speech therapy services are also not covered by this Policy.

Financial Ability

Financial assistance for medically necessary services is available on a sliding scale of up to 100% of charges, and up to a full waiver of co-payments and/or deductible after third-party insurance proceeds, based on financial need (i.e. uninsured and underinsured patients). Patients qualify for 100% financial assistance if their family income is at or below 300% of the Federal Poverty Level Guidelines (FPL). Lesser discounts are available for patients with a family income between 301% and 400% of the Federal Poverty Level Guidelines. For those who qualify for a prorated discount (301% - 400%) under the Policy, Catholic Health will provide a discount for emergency or other medically necessary care up to a maximum of twenty percent (20%) of the amount that would have been paid for the same services by Medicaid; or for underinsured patients, up to a maximum of twenty percent (20%) of the amount that would have been paid pursuant to such patient’s insurance cost sharing. Further, CH will not use gross charges when billing individuals who qualify for financial assistance when such eligibility is known at the time of billing.

Primary Service Area

CH shall extend free or discounted care to eligible individuals, residing in the United States, for medically necessary services. The medical condition of the patient shall not be a factor in determining eligibility.

Applying for Financial Assistance

Catholic Health will accept applications any time during the collection process. Patients requesting financial assistance will be required to complete the Hospital Financial Assistance Application. Financial assistance eligibility is assessed as of the date the application was received. Individuals will be notified when financial assistance applications are deemed incomplete. Such notification shall include the information needed to complete the application.

How to Obtain Information

Download the Policy, plain language summary, application and instructions. Additionally, copies of the Policy, plain language summary, application form and instructions are also available in patient registration and emergency department locations. These documents are available in English and Spanish.

English:

Español:

Assistance understanding the Policy and with the financial assistance application process is available.

Request free copy of the Policy, plain language summary, application and instructions by mail or to obtain more specific details on the Financial Assistance process by contacting the Financial Assistance department:

Catholic Health
Financial Assistance Department
245 Old Country Road
Melville, NY 11747
Tel. number 631-465-6321
Fax number 631- 396-4239