BROOKS-TLC HOSPITAL SYSTEM, INC

DUNKIRK, NY · version 1 · published · JSON

eligibility.free_care_max_fpl200% of the federal poverty level

"Household income less than or equal to 200% of the FPL is awarded 100% discount."

documented · checked 2026-10-11 · Financial Assistance Policy (English)

eligibility.insured_patients_coveredYes

"Underinsured: patients whose paid medical expenses have exceeded 10% of their income in the last 12 months."

documented · checked 2026-10-11 · Financial Assistance Policy (English)

apply.documents_requiredProof of income
Tax return
Pay stubs
Medicaid denial letter

"Brooks-TLC Hospital System, Inc. will require a completed Financial Assistance application and proof of income such as a tax return or pay stubs. We may also request a Medicaid denial letter but not required."

documented · checked 2026-10-11 · [PDF] 1121463 K BMH Financial Assistance Summary

apply.submit_methodsMail: Send a completed form to Brooks-TLC Hospital System, Inc.
In person: leave it with the cashier located in the main registration area.

"Send a completed form to Brooks-TLC Hospital System, Inc. or leave it with the cashier located in the main registration area."

documented · checked 2026-10-11 · [PDF] 1121463 K BMH Financial Assistance Summary

apply.decision_days30 days

"Decisions regarding financial assistance are rendered within 30 days from the receipt date of the completed application."

documented · checked 2026-10-11 · Financial Assistance Policy (English)

contacts.phone716-363-7221

"Please contact our Facilitated Enroller at 716-363-7221 for free confidential assistance."

documented · checked 2026-10-11 · [PDF] 1121463 K BMH Financial Assistance Summary

Sources

Financial Assistance Program - Brooks-TLC Hospital System, Inc. — fetched 2026-10-11

[PDF] 1121463 K BMH Financial Assistance Summary — fetched 2026-10-11

Financial Assistance Program Income Guidelines — fetched 2026-10-11

Financial Assistance Policy (English) — fetched 2026-10-11

Financial Assistance Policy (Spanish) — fetched 2026-10-11

Financial Assistance Policy (Arabic) — fetched 2026-10-11