Financial Assistance Summary

The Brookdale Hospital and Medical Center recognizes that there are times when patients in need of care will have difficulty paying for the services provided.  The Brookdale Hospital 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.  Our Financial Aid Application can be located here.  This Summary applies to Brookdale Hospital Medical Center, Kingsbrook Jewish Medical Center, and Interfaith Medical Center.

Rezime Asistans Finansye
Aplikasyon Èd Finansye

Resumen de ayuda financiera
Aplicación para ayuda financiera

ملخص المساعدة المالية
طلب المساعدة المالي ة

আডথিক সহায়তার সারসংডেপ
আর্থিক সহায়তার আবেদন

费用补助总结
经济补助申请

Краткое изложение порядка предоставления финансовой поддержки
Заявление на получение финансовой поддержки

רעציק ףליה עלעיצנאַ ניפ
פינאַנציעלע הילף אַפּלאַקיישאַ

Financial Aid Policy

Financial Assistance Program Policy

Politik Ak Pwosedi Notifikasyon Èd Finansye Pou Pasyan Nan Lopital Brookdale La

Política y Procedimiento de Notificación de Ayuda Financiera para Pacientes del Hospital de Brookdale

إخطار المساعدة المالية في مستشفى بروكديل للمرضى، الإجراء والسياسة

ব্রুকডেল হাসপাতাডলর ররাগীডের জন্য আর্থিক সহায়তার ন্ীর্ত ও কার্িপ্রণালীর রন্াটির্িডকশন্

布鲁克代尔医院患者经济补助通知政策和程序

ПОЛИТИКА И ПРОЦЕДУРА УВЕДОМЛЕНИЯ ПАЦИЕНТОВ О ФИНАНСОВОЙ ПОДДЕРЖКЕ В БОЛЬНИЦЕ BROOKDALE

ברוקדייל האָספּיטאַל פינאַנציעלע הילף אָנזאָג צו פּאַציענטן פּאָליטיק אונד פראצעדורע

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 $40,770 Up to $3,397 Up to $784
2 Up to $54,930 Up to $4,577 Up to $1,056
3 Up to $69,090 Up to $5,757 Up to $1,329
4 Up to $83,250 Up to $6,937 Up to $1,601
5 Up to $97,410 Up to $8,117 Up to $1,739
6 Up to $111,570 Up to $9,297 Up to $2,145

 

* Based on the 2022 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 cannot 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.