About

The Financial Assistance Program is available to uninsured residents of New York City and Long Island who are ineligible for public health insurance. This program is for assistance paying for a single treatment or service, and applicants must also meet income requirements. To see if you qualify or to apply, please call the Financial Assistance Unit at (800) 995-5727 or complete our online contact form.

Otherwise, please review eligibility requirements and download the online application to apply.

Eligibility

The income restrictions for program eligibility are set based on the federal poverty level and a patient’s household size. To determine your eligibility, consult the table below.

Family Size Maximum Yearly Income
1 $58,850
2 $79,650
3 $100,450
4 $121,250
5 $142,050
6 $162,850
7 $183,650
8 $204,450
9 $225,250
10 $246,050
11 $266,850
12 $287,650

 

Apply

To apply for financial assistance, please download, print, sign and mail us a completed copy of the Financial Assistance application. You may also call for additional help. We offer the application in several languages:

 

Be sure to attach all requested documentation. If we do not receive all of your documentation, we cannot process your application.

Your application will be kept strictly confidential.

 

Filing Time Limits

You have 90 days from the date you received treatment to apply for the Financial Assistance Program.

 

Restrictions

The following items are NOT covered under the Financial Assistance Program:

  • Prescriptions

  • Co-Pays

  • Co-Insurance

  • Deductibles

  • Personal items (e.g., telephone, private room differential, guest meals, etc.)

 

After You Apply

After submitting a complete application with all requested documentation, you can disregard your bill until a final decision is made.

We will contact you within 30 days either by telephone or by mail to inform you of the decision.

 

If Your Application Is Approved

If you are approved, we will let you know your new account balance.

If you need additional help with your new balance, please call the Financial Assistance Unit at (800) 995-5727. We can help you set up a monthly payment plan.

 

If Your Application Is Not Approved

If your application for Financial Assistance is not approved, you can appeal the decision by mailing additional information and/or documents that you would like us to review to Financial Assistance Unit, P.O. Box 9001, Melville, NY 11747. If you do not wish to appeal the decision, please call our Financial Assistance Unit at (800) 995-5727 to set up an affordable monthly payment plan.

Frequently Asked Questions

  1. I received a bill from North Shore-LIJ, but I am uninsured or underinsured and can’t afford to pay it. How can North Shore-LIJ help me?

The North Shore-LIJ Financial Assistance Program provides reduced fees for uninsured or underinsured patients. Eligibility for our program is based on your household income and residency. Please contact us if you have any questions or wish to apply.

If you are eligible or we believe you may be eligible for Medicaid or other Public Health Insurance, we can help you apply. You must fully comply with all state public health insurance documentation requirements before you can apply for Financial Assistance.

  1. Can you tell me more about the household income requirements?

To be eligible for the North Shore-LIJ Financial Assistance Program, you must live in a household with an annual income under 500% of the Federal Poverty Level. You can call us, toll-free, at (888) 214-4065 to speak with a Financial Assistance representative, or you can review our income guidelines at Financial Assistance Program to see if you qualify.

  1. OK, I meet the income requirements. What else does North Shore-LIJ look at when reviewing my request for financial assistance?

We look to see if you live within the North Shore-LIJ service area (Long Island and New York City) and sometimes we will ask you questions about your financial assets.

  1. What charges are not covered by the Financial Assistance Program?

Only services that your doctor thinks are medically necessary will be considered for the Financial Assistance Program. The following items are NOT covered under the Financial Assistance Program: (1) Prescriptions, (2) Co-Pays (3) Co-Insurance (4) Deductibles and (5) personal items (telephone, private room differential, guest meals, etc).

  1. How can I apply for the Financial Assistance Program?

To apply for Financial Assistance please call us at (888) 214-4065 or visit the Financial Assistance Program page to download an application.  (Applications are available in multiple languages.) You have 90 days from the date you received treatment  to apply for the Financial Assistance Program. You will be asked to provide supporting documentation as part of the application. Please review the instructions carefully.

  1. What documentation should I submit with my Financial Assistance Application?

To apply for financial aid, you must provide proof of your current household income and household size. In some instances, you may be asked to provide your recent bank statements of general savings.

  1. If I apply for financial assistance, is this information made public?

    No. All information in your application is kept confidential.

  1. I have completed an application. Now what?

First, make sure that you attach all requested documentation to your application. If we do not receive all of your documentation, we can not process your request.

Please mail your completed application and documents to the Financial Assistance Unit, P.O. Box 9001, Melville, NY 11747. If you have any questions, please call the Financial Assistance Unit at (888) 214-4065.

Once you have submitted a complete application with the requested documentation, you may disregard your bill until a final decision is made.

We will contact you, in writing, within 30 days with a decision on your application. If you are approved, we will let you know what your new account balance is. The Financial Assistance Unit can set up a monthly payment plan if you need help paying your new balance.

  1. What happens if my financial assistance application is denied?

You can appeal the decision by writing to us and submitting any additional information and/or documents that you would like for us to review. If you have additional questions or do not wish to appeal the decision, please call our Financial Assistance Unit at (888) 214-4065 to set up an affordable monthly payment plan.

  1. I was approved for the Financial Assistance Program in the past, but I need more medical care – what should I do?

If you need more medical care, please contact the Financial Assistance Unit so that your prior application can be re-evaluated. It may be necessary for you to provide more up-to-date financial information/documents at that time.