About

The Financial Assistance Program is available to uninsured residents of the various service ares of the Northwell Health hospital facilities who are ineligible for public health insurance. This program is for assistance paying for a single treatment or service, and applicants must also meet income requirements. To see if you qualify or to apply, please call the Financial Assistance Unit at (800) 995-5727 or complete our online contact form.

Otherwise, please review eligibility requirements and download the online application to apply.

Eligibility

The Northwell Health Financial Assistance Program is designed to help patients who have received emergency or other medically necessary services but are uninsured, underinsured or have exhausted their benefits for a particular service. Eligibility for the program is based on current income and is available to individuals with household incomes that are less than those shown below:

Family Size Maximum Yearly Income
1 $60,300
2 $81,200
3 $102,100
4 $123,000
5 $143,900
6 $164,800
For each additional person, add $20,900

When completing an application for financial assistance please remember the following:

  • You are encouraged to apply for financial assistance within 90 days from the date of the first post-discharge billing statement; however you are permitted a minimum of two hundred and forty (240) days to apply and submit a completed application;
  • If an incomplete application is received, Northwell Health will provide a written notice that describes the additional information or documentation required to make a determination with respect to eligibility for financial assistance. You will be given thirty (30) days to provide the additional requested documentation.  The normal billing cycle will continue but any Extraordinary Collection Actions which have been initiated will be suspended during this time until a determination of eligibility for financial assistance is made;
  • Required Documentation – please attach copies of checks, pay stubs or statements that support any of the types of income that are reported on your financial assistance application. In addition, please provide copies of all bills or statements that you would like us to review as part of your application. Note that we reserve the right to request additional documentation related to assets for patients with household incomes under 150% of the federal poverty level;
  • Once we receive your completed application, you can disregard any bills / statements until you receive written notification regarding your financial assistance application; and
  • Applicants for financial assistance will be expected to fully cooperate in applying for any public insurance program (e.g., Medicaid, Child Health Plus, etc.) that Northwell Health believes they may be eligible for.

Please mail your application to the address listed below for the respective hospital facility:

Northwell Health (including North Shore University Hospital, Long Island Jewish Medical Center, Cohen Children’s Medical Center, The Zucker Hillside Hospital, Huntington Hospital, Lenox Hill Hospital, Manhattan Eye, Ear and Throat Hospital, Staten Island University Hospital, Long Island Jewish Valley Stream, Long Island Jewish Forest Hills, Glen Cove Hospital, Plainview Hospital, Southside Hospital and Syosset Hospital)

Northwell Health
Financial Assistance Unit
PO Box 9001
Melville, NY  11747-9001
Phone: 1.800.995.5727

Northern Westchester Hospital Association
Patient Accounts Department
34 South Bedford Road, 2nd Floor
Mount Kisco, NY  10549-1096
Phone: 914.666.1512

Phelps Memorial Hospital Association
Financial Counseling
701 North Broadway
Sleepy Hollow, NY  10591-1096
Phone: 914.366.3133

Peconic Bay Medical Center
Financial Assistance Coordinator
1300 Roanoke Avenue
Riverhead, NY  11901
Phone: 631.548.6099

Apply

To apply for financial assistance, please download, print, sign and mail us a completed copy of the Financial Assistance application. You may also call for additional help. We offer the application in several languages:

Be sure to attach all requested documentation. If we do not receive all of your documentation, we cannot process your application.

Your application will be kept strictly confidential.

Filing Time Limits

You are encouraged to apply for financial assistance within ninety (90) days from the date noted on the first post-discharge date noted on the statement; however, you are permitted a minimum of two hundred and forty (240) days to apply and submit a completed application.

After You Apply

After submitting a complete application with all requested documentation, you can disregard your bill until a final decision is made.

We will contact you within 30 days either by telephone or by mail to inform you of the decision.

If Your Application Is Approved

If you are approved, we will let you know your new account balance.

If you need additional help with your new balance, please call the Financial Assistance Unit at (800) 995-5727. We can help you set up a monthly payment plan.

If Your Application Is Not Approved

If your application for Financial Assistance is not approved, you can appeal the decision by mailing additional information and/or documents that you would like us to review to Financial Assistance Unit, P.O. Box 9001, Melville, NY 11747. If you do not wish to appeal the decision, please call our Financial Assistance Unit at (800) 995-5727 to set up an affordable monthly payment plan.

Frequently Asked Questions

  1. I received a bill from Northwell Health, but I am uninsured or underinsured and can’t afford to pay it. How can Northwell help me?

The Northwell Financial Assistance Program provides reduced fees for uninsured or underinsured patients. Eligibility for our program is based on your household income and residency. Please contact us if you have any questions or wish to apply.

If you are eligible or we believe you may be eligible for Medicaid or other Public Health Insurance, we can help you apply. You must fully comply with all state public health insurance documentation requirements before you can apply for Financial Assistance.

  1. Can you tell me more about the household income requirements?

To be eligible for the Northwell Financial Assistance Program, you must live in a household with an annual income under 500% of the Federal Poverty Level. You can call us, toll-free, at (888) 214-4065 to speak with a Financial Assistance representative, or you can review our income guidelines at Financial Assistance Program to see if you qualify.

  1. OK, I meet the income requirements. What else does Northwell look at when reviewing my request for financial assistance?

We look to see if you live within the Northwell service area and sometimes we will ask you questions about your financial assets.

  1. What charges are not covered by the Financial Assistance Program?

Only services that your doctor thinks are medically necessary will be considered for the Financial Assistance Program. The following items are NOT covered under the Financial Assistance Program: (1) Prescriptions, (2) Co-Pays (3) Co-Insurance (4) Deductibles and (5) personal items (telephone, private room differential, guest meals, etc).

  1. How can I apply for the Financial Assistance Program?

To apply for Financial Assistance please call us at (888) 214-4065 or visit the Financial Assistance Program page to download an application.  (Applications are available in multiple languages.) You have 90 days from the date you received treatment  to apply for the Financial Assistance Program. You will be asked to provide supporting documentation as part of the application. Please review the instructions carefully.

  1. What documentation should I submit with my Financial Assistance Application?

To apply for financial aid, you must provide proof of your current household income and household size. In some instances, you may be asked to provide your recent bank statements of general savings.

  1. If I apply for financial assistance, is this information made public?

    No. All information in your application is kept confidential.

  1. I have completed an application. Now what?

First, make sure that you attach all requested documentation to your application. If we do not receive all of your documentation, we can not process your request.

Please mail your completed application and documents to the Financial Assistance Unit, P.O. Box 9001, Melville, NY 11747. If you have any questions, please call the Financial Assistance Unit at (888) 214-4065.

Once you have submitted a complete application with the requested documentation, you may disregard your bill until a final decision is made.

We will contact you, in writing, within 30 days with a decision on your application. If you are approved, we will let you know what your new account balance is. The Financial Assistance Unit can set up a monthly payment plan if you need help paying your new balance.

  1. What happens if my financial assistance application is denied?

You can appeal the decision by writing to us and submitting any additional information and/or documents that you would like for us to review. If you have additional questions or do not wish to appeal the decision, please call our Financial Assistance Unit at (888) 214-4065 to set up an affordable monthly payment plan.

  1. I was approved for the Financial Assistance Program in the past, but I need more medical care – what should I do?

If you need more medical care, please contact the Financial Assistance Unit so that your prior application can be re-evaluated. It may be necessary for you to provide more up-to-date financial information/documents at that time.

(800) 995-5727

Are you eligible?

Call the Financial Assistance Unit to find out if you qualify for any of our financial aid programs or to arrange a payment plan.

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