LONG ISLAND JEWISH MEDICAL CENTER

"Patients qualify for 100% financial assistance if their family income is at or below 300% of the Federal Poverty Level Guidelines (FPL)."

documented · checked 2026-10-13 · Financial Assistance Policy | Catholic Health Long Island

"Eligibility Percentage 100% 90% 80% % of Poverty Level 0% - 300% 301% - 350% 351% - 400%"

documented · checked 2026-10-13 · **Financial Assistance Eligibility Percentages**

"Financial assistance for medically necessary services is available on a sliding scale of up to 100% of charges, and up to a full waiver of co-payments and/or deductible after third-party insurance proceeds, based on financial need (i.e. uninsured and underinsured patients)."

documented · checked 2026-10-13 · Financial Assistance Policy | Catholic Health Long Island

"Acceptable forms of documentation to support family income (patient/guarantor and spouse) include the following: o Four (4) most recent pay stubs o Copy of Social Security payments that you and/or your spouse receive (benefit award letter or bank statement) o Copy of unemployment benefits o Copy of workers compensation benefits o Other income (e.g., alimony/maintenance, rental income, veterans’ benefits) o Three (3) most recent bank statements (checking and savings) (all pages) o Proof of student status (unofficial transcript or current class schedule) o Proof of support assistance from another person (letter from person supporting you if you are not paying rent) o Prior year tax return"

documented · checked 2026-10-13 · [PDF] Catholic Health Services of Long Island

"Upon receipt of your completed application and all required documents, your application will be reviewed and our determination will be sent to you in writing within thirty (30) days."

documented · checked 2026-10-13 · [PDF] Catholic Health Services of Long Island

"Tel. number 631-465-6321"

documented · checked 2026-10-13 · Financial Assistance | Catholic Health Long Island

"These documents are available in English and Spanish."

documented · checked 2026-10-13 · Financial Assistance | Catholic Health Long Island

"System Hospital – A hospital within the Catholic Health System that is required by New York State to be licensed or registered or similarly recognized as a hospital, including Good Samaritan University Hospital, Mercy Hospital, St."

documented · checked 2026-10-13 · Financial Assistance Policy | Catholic Health Long Island