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.