O'CONNOR HOSPITAL

"Below 200% FPL Waive all charges"

documented · checked 2026-10-14 · Charity Care & Financial Assistance (English)

"Underinsured individuals within federal poverty levels of 201-400% and with paid out-of-pocket medical expenses that are greater than ten (10) percent of their annual gross income for the prior twelve months."

documented · checked 2026-10-14 · Charity Care & Financial Assistance (English)

"Please include the income information for the patient, their spouse, and any dependents (such as children). For example, this would include everyone on the same tax return (tax filer, spouse, and tax dependents) in the calculation of household income. The following is a list of documents you can use to prove your income. You do not have to provide all these documents. You can also provide a statement of no household income if you have no income. 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. Unemployment Compensation$Copy of award letter/certificate, or monthly benefit statement from NYS Department of Labor, or Copy of Direct Payment Card with printout, or Correspondence from the NYS Department of Labor, or Printout of recipient’s account information from the NYS Department of Labor’s website (www.labor.state.ny.us). Disability Payment$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. 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 2026-10-14 · Bassett NYS Uniform Hospital Financial Assistance Application (English)

"Fox Memorial Hospital Financial Assistance Representative Business Office 1 Norton Avenue Oneonta, NY 13820"

documented · checked 2026-10-14 · Financial Assistance Resource Guide

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

documented · checked 2026-10-14 · Bassett NYS Uniform Hospital Financial Assistance Application (English)

"If you need assistance with this application, please contact Bassett Healthcare Network’s financial assistance office at (607-547-3093)."

documented · checked 2026-10-14 · Bassett NYS Uniform Hospital Financial Assistance Application (English)

"☒ O’Connor Hospital"

documented · checked 2026-10-14 · Charity Care & Financial Assistance (English)