BROOKDALE HOSPITAL MEDICAL CENTER

"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 2026-10-10 · Financial Assistance | The Brooklyn Hospital Center

"You may be eligible if you have no health insurance (uninsured) or if you have health insurance with high out-of-pocket costs that you are not able to pay (underinsured)."

documented · checked 2026-10-10 · Financial Assistance | The Brooklyn Hospital Center

"[TBHC Financial Assistance Application Package](https://www.tbh.org/sites/default/files/2026-07/2026-tbhc-financial-assistance-application-package.docx)"

documented · checked 2026-10-10 · Financial Assistance | The Brooklyn Hospital Center

"You may also provide the Eligibility determination page from the NY State of Health Marketplace. If you have this document, you do not have to provide any other income information listed below to the hospital. **If Household****Receives:****Amount****per****Month:****Applicant****May****Provide:** Wages$Please provide one Paycheck Stub, or Letter from Employer on company letterhead,signed and dated, or most recently filed income tax return. Social Security Payment$Copy of award letter/certificate, or correspondence from the U.S. Social Security Administration, or annual benefit letter.To request a copy of your Social Security benefit letter, call 1-800-772-1213 or visit [www.ssa.gov.](http://www.ssa.gov/) Unemployment Compensation$Copy of award letter/certificate, or monthly benefit statement from NYS Department of Labor,or Copy of Direct Payment Card with printout, or Correspondence from the NYS Department of Labor, or Printout of recipient’s account information from the NYS Department of Labor’s website [(www.labor.state.ny.us).](http://www.labor.state.ny.us/) Disability Payment$Copy of award letter/certificate, or correspondence from Social Security Administration,or copy of annual benefit letter.To request a copy of your benefit letter, call 1-800-772-1213 or visit [www.ssa.gov.](http://www.ssa.gov/) Workers Compensation$Copy of Award Letter or Check stub. Alimony/Child Support$Copy of court order,or 3 months of cashed checks/receipts. Dividends/Interest$Quarterly dividend statements or 1 month statements. Other$Letter stating the amount of non-wage earnings (if any),such as rental income,cash for odd jobs,etc. No Income$0 Signed statement of no income."

documented · checked 2026-10-10 · TBHC Financial Assistance Application Package

"Submit a complete financial assistance application with all required documentation via mail, or by working with one of our Financial Counselors in person or via phone. You can get an application in any of the following ways: * Online via the hospital’s website at: [https://www.tbh.org/visitor-information/billing/financial-assistance](https://www.tbh.org/visitor-information/billing/financial-assistance) * At any of the main hospital’s registration desks and any of the hospital clinics * By contacting the Financial Counselors Unit at 718-250-8080 * Mailing address: The Brooklyn Hospital Center Attn: Financial Counselors Unit, 2nd Floor 121 DeKalb Avenue, Brooklyn, NY 11201"

documented · checked 2026-10-10 · Financial Assistance | The Brooklyn Hospital Center

"Once the patient has submitted an application the patient may disregard all bills until a determination has been made on the application. A decision will be made within 30 days of receipt of completed application."

documented · checked 2026-10-10 · TBHC Financial Assistance Policy

"* Hospitals cannot send unpaid bills to a collection agency for at least 180 days after your first bill."

documented · checked 2026-10-10 · TBHC Financial Assistance Application Package

"By contacting the Financial Counselors Unit at 718-250-8080"

documented · checked 2026-10-10 · Financial Assistance | The Brooklyn Hospital Center