{"hospital":{"ccn":"220002","name":"MOUNT AUBURN HOSPITAL","city":"CAMBRIDGE","state":"MA","zip":"02138","phone":"617-492-3500","ownership":"Voluntary non-profit - Private","website_domain":"mountauburnhospital.org","system":null},"version":5,"status":"published","eligibility":{"free_care_max_fpl":{"value":"400","layer":"documented","quote":"Charity Care: MAH will provide care at 100% discount under this policy for patients/Guarantors whose Family Income is at or below 400% of the current FPL, who otherwise meet other eligibility criteria set forth in this policy.","source_id":"fap-f53b8d063a20ae21","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"discount_tiers":null,"asset_test":null,"residency":null,"insured_patients_covered":null,"min_balance":null,"services_excluded":null},"programs":{"presumptive":null,"state_programs":{"value":[{"name":"Health Safety Net (Massachusetts)","how_to_apply":"Apply through the MassHealth application; a hospital financial counselor can file it for you. The hospital's own financial assistance and the Health Safety Net are separate programs."}],"layer":"documented","quote":"Important information you need to know about applying for MassHealth Limited and the Health Safety Net can be found on page 3.","source_id":"state-mass-cafb5ebe5d7f","checked_on":"2026-10-02","confidence":1.0,"support_count":0}},"apply":{"form_url":{"value":"https://www.mountauburnhospital.org/patients-visitors/billing-insurance/billing-policies/","layer":"documented","quote":"On the MAH public website: https://www.mountauburnhospital.org/patients-visitors/billinginsurance/billing-policies/","source_id":"fap-f53b8d063a20ae21","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"form_version":null,"documents_required":{"value":["proof_of_income","tax_return","pay_stubs","bank_statements","other"],"layer":"documented","quote":"In addition to the Financial Assistance Application we also need the following documentation attached to this application: • Current state or federal income tax returns • Current Forms W2 and/or Forms 1099 • Four most recent payroll stubs • Four most recent checking and/or savings account statements • Health savings accounts • Health reimbursement arrangements • Flexible spending accounts","source_id":"application-75f0e5b42cb5bbbf","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"mail","detail":"Return Application to: Mount Auburn Hospital Financial Assistance Department 330 Mount Auburn Street, Clark Building, 2nd Floor Cambridge, MA 02138"},{"kind":"in_person","detail":"Return Application to: Mount Auburn Hospital Financial Assistance Department 330 Mount Auburn Street, Clark Building, 2nd Floor Cambridge, MA 02138"},{"kind":"portal","detail":"On the MAH public website: https://www.mountauburnhospital.org/patients-visitors/billinginsurance/billing-policies/"}],"layer":"documented","quote":"Mount Auburn Hospital Financial Assistance Department 330 Mount Auburn Street, 1st Floor Needham Building, Cambridge, MA 02138 • Request copies to be mailed or sent electronically by calling (617) 499-5560 (you may also call this number to request assistance with the application process)","source_id":"summary-80dcd7513bfd19d1","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"window_days_from_first_bill":{"value":240,"layer":"documented","quote":"The deadline to return the application is 240 days from the first billing statement for the services which financial assistance is being requested.","source_id":"application-75f0e5b42cb5bbbf","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"decision_days":{"value":30,"layer":"documented","quote":"Please allow 30 days from the date the completed application is received for eligibility determination.","source_id":"application-75f0e5b42cb5bbbf","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"decision_days_reported":null},"collections":{"eca_wait_days":null,"collection_agencies":null},"contacts":{"phone":{"value":"(617) 499-5560","layer":"documented","quote":"Phone: (617) 499-5560","source_id":"application-75f0e5b42cb5bbbf","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"hours":null,"languages":{"value":["English","Spanish","French","Haitian Creole","Simplified Chinese","Traditional Chinese","Portuguese","Greek","Russian","Armenian"],"layer":"documented","quote":"Financial Assistance Policies, Applications and Plain Language Summaries are available in the following languages: English Spanish French Haitian Creole Simplified Chinese Traditional Chines Portuguese Greek Russian Armenian","source_id":"summary-80dcd7513bfd19d1","checked_on":"2026-10-09","confidence":1.0,"support_count":0}},"coverage":{"facilities":{"value":["Anna Jaques Hospital","Addison Gilbert Hospital","BayRidge Hospital","Beth Israel Deaconess Medical Center","Beth Israel Deaconess Hospital-Milton","Beth Israel Deaconess Hospital-Needham","Beth Israel Deaconess Hospital-Plymouth","Beverly Hospital","Lahey Hospital & Medical Center","Lahey Medical Center, Peabody","Mount Auburn Hospital","New England Baptist Hospital","Winchester Hospital"],"layer":"documented","quote":"If eligible, financial assistance is granted for six months from the date of approval and is valid for all Beth Israel Lahey Health affiliates as set forth in Appendix 5 of their respective Financial Assistance Policies: • Anna Jaques Hospital • Addison Gilbert Hospital • BayRidge Hospital • Beth Israel Deaconess Medical Center-Boston • Beth Israel Deaconess Milton • Beth Israel Deaconess Needham • Beth Israel Deaconess Plymouth • Beverly Hospital • Lahey Hospital & Medical Center, Burlington • Lahey Medical Center, Peabody • Mount Auburn Hospital • New England Baptist Hospital • Winchester Hospital","source_id":"application-75f0e5b42cb5bbbf","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"application-75f0e5b42cb5bbbf","kind":"hospital_web","url":"https://mountauburnhospital.org/-/media/files/mount-auburn/mah-application-for-financial-assistance-english.pdf","title":"mah-application-for-financial-assistance- ...","fetched_on":"2026-10-09","sha256":"75f0e5b42cb5bbbf8d95780abdf293e668b30e667ce25742aef40972a80668e3","effective_date":null},{"id":"summary-80dcd7513bfd19d1","kind":"hospital_web","url":"https://mountauburnhospital.org/-/media/files/mount-auburn/mah-fap-summary-english.pdf","title":"Financial Assistance Policy Plain Language 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經濟援助政策","fetched_on":"2026-10-09","sha256":"8790ff1effcc7b9d0a176d3a1691696c19bf4b1375f16041cde25b36dc2c88c2","effective_date":null},{"id":"state-mass-cafb5ebe5d7f","kind":"state_repository","url":"https://www.mass.gov/doc/senior-guide-to-health-care-coverage-4/download","title":"download","fetched_on":"2026-10-02","sha256":"cafb5ebe5d7fd181e3c87567b6609c3aa6ee7fff9af006d521a3a53700a99472","effective_date":null}],"accuracy":null}