MONTEFIORE MOUNT VERNON HOSPITAL

"If your family income is less than or equal to 200% of the FPG, you may qualify for free hospital or hospital clinic care."

documented · checked 2026-10-14 · Financial Assistance Summary and Application (English)

"Montefiore Medical Center also provides payment arrangements to patients that have insurance coverage but have an out-of-pocket expense that they cannot afford or deem a hardship."

documented · checked 2026-10-14 · Financial Assistance Summary and Application (English)

"Just call or visit a Financial Counselor at sites listed on Page 2 or email financialaid@montefiore.org for free, confidential assistance. More information about the financial assistance policy can be found at http://www.montefiore.org/financial-aid-policy. You can also receive an application at no cost via mail. Who qualifies for a discount? Financial Assistance is available for patients with no health insurance or limited health insurance coverage that reside in the medical center’s primary service area (New York State). Montefiore Medical Center also provides payment arrangements to patients that have insurance coverage but have an out-of-pocket expense that they cannot afford or deem a hardship. Everyone in New York State who needs emergency or medically necessary services can receive care and get a discount. You cannot be denied emergency or medically necessary care because you need financial assistance. You may apply for a discount regardless of immigration status. 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 or limited health insurance, these are the income limits: 2026 Federal Poverty Level 1 2 3 4 5 Family Size BELOW 200% 200%-300% 301%-400% 401%-500% over 500% 1 $31,920 $47,880 $63,840 $79,800 2 $43,280 $64,920 $86,560 $108,200 3 $54,640 $81,960 $109,280 $136,600 4 $66,000 $99,000 $132,000 $165,000 5 $77,360 $116,040 $154,720 $193,400 6 $88,720 $133,080 $177,440 $221,800 7 $100,080 $150,120 $200,160 $250,200 8 $111,440 $167,160 $222,880 $278,600 For each additional person Add. $11,360 $17,400 $22,720 $28,400 * Based on the 2026 Federal Poverty Guidelines If your family income is less than or equal to 200% of the FPG, you may qualify for free hospital or hospital clinic care. If your family income is between 201% and 500% of the FPG, you may qualify for partial financial assistance. If eligible, you will not be billed more than the amount generally billed to insured persons for the care provided. What if I do not meet the income limits? If you cannot pay your bill, Montefiore Medical Center has a financial assistance category for all who apply. The percentage of the discount depends on your annual income and family size. We also offer extended payment plans and the monthly payment will not exceed 5 percent of your monthly income. A self-pay discount is available for patients above 500% of the federal poverty level. Self-pay discounts are also available for non-medically necessary services. Can someone explain the discount? Can someone help me apply? Yes, free, confidential help is available. If you do not speak English, someone will help you in your own language. Applications, summaries, and the full policy are also available in multiple languages at no cost. The Financial Counselor can tell you if you qualify for free or low-cost insurance, such as Medicaid, Child Health Plus or a Qualified Health Plan (during open enrollment). If the Financial Counselor finds that you don’t qualify for low-cost insurance, they will help you apply for a discount. The Counselor will help you fill out all the forms and tell you what documents you need to bring. Please visit one of the locations below or http://www.montefiore.org/financial-aid-policy for additional information or assistance."

documented · checked 2026-10-14 · Financial Assistance Summary and Application (English)

"Acceptable proof of income: • Unemployment statement • Social Security/Pension Award letter • Paystubs/Employment verification letter • Letter of support • Self attestation letter (in appropriate circumstances) • Tax Return or W2"

documented · checked 2026-10-14 · Financial Assistance Summary and Application (English)

"Montefiore Medical Center 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."

documented · checked 2026-10-14 · Financial Assistance Summary and Application (English)