{"hospital":{"ccn":"220075","name":"MASSACHUSETTS EYE AND EAR INFIRMARY -","city":"BOSTON","state":"MA","zip":"02114","phone":"617-523-7900","ownership":"Voluntary non-profit - Private","website_domain":"massgeneralbrigham.org","system":null},"version":3,"status":"published","eligibility":{"free_care_max_fpl":{"value":"150","layer":"documented","quote":"Family Income % FPG Discount 0 to 150% 100%","source_id":"fap-111a492d2aab30fc","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"discount_tiers":{"value":[{"min_fpl_exclusive":"150","max_fpl_inclusive":"250","discount_percent":85},{"min_fpl_exclusive":"250","max_fpl_inclusive":"300","discount_percent":70}],"layer":"documented","quote":"Family Income % FPG Acute Care Hospitals listed in Appendix 1 EXCEPT WDH Wentworth-Douglass Hospital (WDH) 0 to 150% 100%1 100% 150.1 to 250% 85%2 100% 251 to 300% 70%3 0%","source_id":"fap-111a492d2aab30fc","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"asset_test":{"value":true,"layer":"documented","quote":"Assets will also be used when: • Patient’s residency is outside the U.S. or Canada. • Patient is deceased, determination must include review of the estate. • Patient has been determined to be ineligible and is appealing for individual consideration due to unique circumstances. • When a patient is covered by Medicare, excluding Medicare Advantage Plans, there is a goal to report any balances written off as Medicare Bad Debt. Balances can only be co-insurance or deductibles, the patient family must be less than 201% of the FPG, the patient must issue a declaration that they are unable to pay the balances, including use of assets.","source_id":"fap-111a492d2aab30fc","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"residency":null,"insured_patients_covered":{"value":false,"layer":"documented","quote":"Financial Assistance may be provided to patients with limited financial resources to make Medically Necessary healthcare services more affordable for those patients who do not qualify for government sponsored insurance programs (such as Medicaid or Medicare), cannot afford their Medicare premium, or are enrolled in Health Safety Net (HSN) or MassHealth Limited to provide more comprehensive coverage of services.","source_id":"fap-111a492d2aab30fc","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"min_balance":null,"services_excluded":null},"programs":{"presumptive":{"value":["Health Safety Net"],"layer":"documented","quote":"Per Section III(F)(2) below, patients with Health Safety Net Full and Health Safety Net Partial will be presumptively eligible for Financial Assistance- patients will be able to seek care for eligible services (per Section III(C)) without a Financial Assistance Application.","source_id":"fap-111a492d2aab30fc","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"state_programs":null},"apply":{"form_url":null,"form_version":null,"documents_required":null,"documents_reported":null,"submit_methods":null,"window_days_from_first_bill":null,"decision_days":null,"decision_days_reported":null},"collections":{"eca_wait_days":null,"collection_agencies":null},"contacts":{"phone":null,"hours":null,"languages":{"value":["English","Arabic / عربى","Chinese (Traditional) / 中文","Haitian Creole / Kreyòl Ayisyen","Indonesian / Bahasa Indonesia","Khmer (Cambodian) / ខ្មែរ","Portuguese (Brazilian) / Português","Russian / русский","Spanish / Español","Vietnamese / Tiếng Việt"],"layer":"documented","quote":"[Financial Assistance Policy - Plain language version / Règleman konsènan Èd Finansye - vèsyon langaj òdinè (PDF)](/content/dam/unified-xwalk/documents/ht/patients-visitors/financial-assistance-summary-haitian-creole.pdf)","source_id":"fap-dc0301e9ce23d133","checked_on":"2026-10-13","confidence":1.0,"support_count":0}},"coverage":{"facilities":{"value":["Mass Eye and Ear Main Campus","Mass Eye and Ear Longwood Campus"],"layer":"documented","quote":"**Mass Eye and Ear Longwood Campus**","source_id":"application-4a93d4901ba08d88","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"fap-dc0301e9ce23d133","kind":"hospital_web","url":"https://massgeneralbrigham.org/patient-information/financial-assistance","title":"Financial Assistance | Mass General Brigham","fetched_on":"2026-10-13","sha256":"dc0301e9ce23d133fc7baeb08ba9d788bae7469a098fc239fbb58c1a7fb6a43e","effective_date":null},{"id":"application-4a93d4901ba08d88","kind":"hospital_web","url":"https://www.massgeneralbrigham.org/content/dam/mgb-global/en/patient-care/patient-and-visitor-information/financial-assistance/documents/assistance-information/english/financial-assistance-application-english.pdf","title":"Financial Assistance | Mass General Brigham","fetched_on":"2026-10-13","sha256":"4a93d4901ba08d88cc7faa3bfd5b6218eddf013f69dec6f01f20ce3ee417f3cf","effective_date":null},{"id":"billing-dc0301e9ce23d133","kind":"hospital_web","url":"https://www.massgeneralbrigham.org/en/patients-visitors/billing-insurance/billing/financial-assistance","title":"Financial Assistance | Mass General Brigham","fetched_on":"2026-10-13","sha256":"dc0301e9ce23d133fc7baeb08ba9d788bae7469a098fc239fbb58c1a7fb6a43e","effective_date":null},{"id":"fap-dc0301e9ce23d133","kind":"hospital_web","url":"https://www.massgeneralbrigham.org/patient-information/financial-assistance","title":"Financial Assistance | Mass General Brigham","fetched_on":"2026-10-13","sha256":"dc0301e9ce23d133fc7baeb08ba9d788bae7469a098fc239fbb58c1a7fb6a43e","effective_date":null},{"id":"fap-111a492d2aab30fc","kind":"hospital_web","url":"https://www.massgeneralbrigham.org/content/dam/unified-xwalk/documents/en/patients-visitors/financial-assistance-policy-english.pdf","title":"Financial Assistance Policy - 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