Financial Information
Hospital Charges
One Brooklyn Health System at Kingsbrook Jewish Medical Center
recognizes that there are times when patients in need of care will have
difficulty paying for the services provided. One Brooklyn Health System at Kingsbrook Jewish Medical Center
Financial Aid Program provides discounts to qualifying individuals based
on your income. In addition, we can help you apply for free or low-cost
insurance if you qualify. Just contact our Financial Counselor at 718-240-5240,
or go to the Brookdale Hospital Financial Office on the Fourth Floor of
the Snapper Building at 1 Brookdale Plaza, Brooklyn, NY, 11212, for free,
confidential assistance.
Who qualifies for a discount?
Financial Assistance is available for patients with limited incomes and
no health insurance.
The program is also available for patients whose medically necessary services
are not covered by their health insurance or who have exhausted their
insurance benefits. Co-pays and deductibles are covered by the program.
Everyone who needs emergency services can receive care and get a discount
if they meet the income limits.
You may apply for a discount regardless of immigration status.
What are the income limits?
The amount of the discount varies based on your income and the size of
your family. If you have no health insurance, these are the income limits:
Depending on circumstances, you may qualify for financial assistance even
if your income exceeds these limits.
Family size
|
Annual
Family Income
|
Monthly
Family Income
|
Weekly
Family Income
|
1
|
Up to $38,640
|
Up to $3,220
|
Up to $743
|
2
|
Up to $52,260
|
Up to $4,355
|
Up to $1,005
|
3
|
Up to $65,880
|
Up to $5,490
|
Up to $1,267
|
4
|
Up to $79,500
|
Up to $6,625
|
Up to $1,529
|
5
|
Up to $93,120
|
Up to $7,760
|
Up to $1,791
|
6
|
Up to $106,740
|
Up to $8,895
|
Up to $2,053
|
* Based on the 2021 Federal Poverty Guidelines – for current rates
refer to the current Financial Aid Grid
What if I do not meet the income limits?
If you cannot pay your bill,
Brookdale Hospital offers a payment plan to those patients that meet the income limits. The
amount you pay depends on the amount of your income.
Depending on circumstances, you may qualify for a payment plan even if
your income exceeds these limits.
Can someone explain the discount? Can someone help me apply?
Yes, free, confidential help is available. Call
the Financial Office at
718-240-5240.
If you do not speak English, someone will help you in your own language.
The Financial Counselor can tell you if you qualify for free or low-cost
insurance, such as Medicaid, Child Health Plus and a Qualified Health Plan.
If the Financial Counselor finds that you don’t qualify for low-cost
insurance, they will help you apply for a discount.
The Counselor will help you fill out all the forms and tell you what documents
you need to bring.
What do I need to apply for a discount?
To apply for financial assistance, you will need a form of picture ID,
proof of address, four weeks of pay stubs, and/or a statement of earnings
and/or letter indicating how you are supporting yourself or are being
supported.
If you can not provide any of these, you may still be able to apply for
financial assistance.
What services are covered?
All medically necessary services provided by
Brookdale Hospital are covered by the discount. This includes outpatient services, emergency
care, and inpatient admissions.
Charges from
private doctors who provide services in the hospital may be covered. You should talk to
private doctors to see if they offer a discount or payment plan.
How much do I have to pay?
The amount for an outpatient service or the emergency room starts from
$0 for children and pregnant women, depending on your income. The amount
for outpatient service or the emergency room starts from $15 for adults,
depending on your income.
Our Financial Counselor will give you the details about your specific discount(s)
once your application is processed.
Patient deposits are based on the patient’s ability to pay and will
be consistent with other financial aid being provided. Generally, payment
arrangements (installment plans) will be offered to eligible patients
(i.e., those with monthly incomes up to 300% of the Federal Poverty Level).
Monthly installment payments are capped at 10% of the patient’s
gross monthly income.
How do I get the discount?
You have to fill out the application form. As soon as we have proof of
your income, we can process your application for a discount according
to your income level.
You can apply for a discount before you have an appointment, when you come
to the hospital to get care, or when the bill comes in the mail.
Send the completed form to
the Brookdale Hospital Financial Office at 1 Brookdale Plaza – Snapper
Building, Fourth Floor, Brooklyn, NY 11212-3198 or bring it
directly to
the Financial Office at the address indicated.You have up to 90 days after receiving services to submit the application.
How will I know if I was approved for the discount?
Brookdale Hospital will send you a letter within 30 days after completion and submission
of documentation, telling you if you have been approved and the level
of discount received.
What if I receive a bill while I’m waiting to hear if I can get a discount?
You cannot be required to pay a hospital bill while your application for
a discount is being considered. If your application is turned down, the
hospital must tell you why in writing and must provide you with a way
to appeal this decision to a higher level within the hospital.
What if I have a problem I cannot resolve with the hospital?
You may call the New York State Department of Health complaint hotline
at 1-800-804-5447.