BILLING CENTER
- Billing Information
- Insurance Plans Accepted
- Balanced Billing Disclosure Notice (No Surprise Bill Disclosure Notice)
- Notice of Right to Receive a Good Faith Estimate of Expected Charges
FINANCIAL ASSISTANCE PROGRAM
- Financial Assistance Summary
- Spanish - Resumen sobre Asistencia Financiera
- Bengali - আর্থিক সহায়তা সারাংশ
- Chinese Simplified - 财务援助简介
- Chinese Traditional - 財務援助簡介
- NYS Uniform Hospital Financial Assistance Application
- Spanish - Solicitud Uniforme de Asistencia Financiera Hospitalaria del Estado de Nueva York
- Bengali - এনওয়াইএস ইউননফর্ম হ়াসপ়াত়ালে আনথমক সহ়াযত়ার জনয আলেদনপত্র
- Chinese Simplified - 纽约州医院财务协助申请表
- Chinese Traditional - 紐約州醫院財務協助申請表
- Financial Assistance Provider List
- Financial Assistance Payment Grid
- Financial Assistance Policy & Procedures
NYS HEALTH INSURANCE EXCHANGE
Paying For Your Care
The Jamaica Hospital Medical Center Financial Assistance Summary
The Jamaica Hospital Medical Center recognizes that there are times when patients in need of care will have difficulty paying for the services provided. The Jamaica Hospital Financial Assistance Program provides discounts to qualifying individuals based on your income. In addition, we can help you apply for free or low-cost insurance if you qualify. For further help, please contact our Financial Office at 718-206-8270. You can also visit us directly at the Jamaica Hospital Financial Office, located at 90-28 Van Wyck Expressway, 2nd Floor, Richmond Hill, NY, 11418, for free, confidential assistance.
To obtain a free copy of our Financial Assistance Policy (FAP) and FAP application, you can do any of the following:
-
- E-mail us at [email protected]
- Go to our website at www.jamaicahospital.org and click on the banner for “Financial Assistance” where you will be able to download the FAP Summary and FAP application
- Request information by writing to us at the above address, Attention: Financial Office
Our FAP and FAP application is available in Spanish, Chinese (Traditional/Simplified), and Bengali.
Who qualifies for a discount?
Financial assistance is available for emergency, and non-emergency medically necessary, services to uninsured and under-insured patients, with incomes up to 400% of the Federal Poverty Level (FPL), who complete a financial assistance application with the Hospital.
An “under-insured” individual, for the purpose of qualifying for financial assistance, is defined as an individual with a household income up to 400% of the FPL and individual out-of-pocket medical payments accumulated in the past 12 months that amount to 10%, or more, of the individual’s household gross income.
The program is also available for patients whose medically necessary services are not covered by their health insurance or who have exhausted their insurance benefits. All qualifying individuals for financial assistance will not be charged more than the amounts generally billed (AGB) to Medicaid for any emergency or medical services rendered.
Everyone residing in New York State who needs emergency services can receive care and get a discount if they meet the income and eligibility requirements.
For Jamaica Hospital, everyone who lives in Queens, the Bronx, Kings (Brooklyn), New York (Manhattan), Richmond (Staten Island), or Nassau County can get a discount on non-emergency, medically necessary services, if they are uninsured and meet the income and other financial assistance requirements.
You may apply for financial assistance regardless of immigration status.
Cosmetic procedures/services are not covered by the program.
What are the income limits?
The amount of the discount varies based on your income and the size of your family. If you have no health insurance, these are the income limits: Depending on circumstances, you may qualify for financial assistance even if your income exceeds these limits.
Family size | Annual
Family Income |
Monthly
Family Income |
Weekly
Family Income |
1 | Up to $60,240 | Up to $5,020 | Up to $1,160 |
2 | Up to $81,760 | Up to $6,816 | Up to $1,576 |
3 | Up to $103,280 | Up to $8,608 | Up to $1,988 |
4 | Up to $124,800 | Up to 10,400 | Up to $2,400 |
5 | Up to $146,320 | Up to 12,196 | Up to $2,816 |
6 | Up to $167,840 | Up to 13,988 | Up to $3,228 |
- Based on 400% of the 2024 Federal Poverty Guidelines
How much do I have to pay?
The payment amounts for an outpatient service or the emergency room for financial assistance recipients starts from $0 and will increase depending on your income and family size.
Our Financial Counselors will give you the details about your specific discount(s) once your application is completed and processed.
Generally, payment arrangements (installment plans) will be offered to eligible patients (i.e., those with monthly incomes up to 400% of the FPL). Monthly installment payments are capped at 5% of the patient’s gross monthly income. Payment arrangements are also available to patients who demonstrate financial hardship.
Can someone explain the discount? Can someone help me apply?
Yes, free, confidential help is available. Call the Financial Office at 718-206-8270. If you do not speak English, someone will help you in your own language.
The Financial Counselor can tell you if you qualify for free or low-cost insurance, such as Medicaid, Child Health Plus, Qualified Health Plan or Financial Assistance.
If the Financial Counselor finds that you do not qualify for low-cost insurance, they will help you apply for a discount via financial assistance. The Financial Counselor will help you fill out all the forms and tell you what documents you need to bring.
What do I need to apply for a discount?
To apply for financial assistance, you will need a form of picture ID, proof of address, four weeks of pay stubs or last year’s W-2, and/or a statement indicating how you are supporting yourself or are being supported.
If you cannot provide any of these documents, you may still be able to apply for financial assistance depending on circumstances.
What services are covered?
All medically necessary services provided by Jamaica Hospital are covered by the discount. This includes outpatient services, emergency care, and inpatient admissions.
Charges from private doctors who provide services in the hospital may not be covered. You should talk to private doctors to see if they offer a discount or payment plan.
How do I get the discount?
You must fill out the application form. As soon as we have proof of your income and family size, insurance status and proof medical payments (if applicable), we can process your application for a discount according to your income level.
You can apply for a discount before you have an appointment, when you come to the hospital to get care, or when the bill comes in the mail.
Send the completed form to the Jamaica Hospital Financial Office at 90-28 Van Wyck Expressway, 2nd Floor, Richmond Hill, New York, 11418 or bring it directly to the Financial Office at the address indicated.
How will I know if I was approved for the discount?
Jamaica Hospital will send you a letter within 30 days after completion and submission of documentation, telling you if you have been approved and the level of discount received.
What if I receive a bill while I’m waiting to hear if I can get a discount?
You cannot be required to pay a hospital bill while your application for a discount is being considered. If your application is turned down, the hospital must tell you why in writing and must provide you with a way to appeal this decision to a higher level within the hospital.
What if I have a problem I cannot resolve with the hospital?
You may call the New York State Department of Health complaint hotline at 1-800-804-5447.
Revised 11/2024