Financial Assistance Program (Financial Assistance Summary)

At Samaritan Medical Center, we understand that medical bills can be stressful. Our Financial Assistance Program is here to help patients who are uninsured, underinsured, or experiencing financial hardship pay for emergency or medically necessary inpatient/outpatient services.

Who can receive financial assistance?

Financial Assistance is available for patients with limited incomes, no insurance, those who are under insured, and to patients with high deductibles or co-insurance amounts.

Anyone who is a resident of New York State and needs emergency or medically necessary services at Samaritan Medical Center are eligible for a discount if they meet the income levels. You cannot be denied medically necessary care because you need financial assistance. You may apply for a discount regardless of immigration status.

What discounts are available? (based on Federal Poverty Levels)

Individuals up to 400% of the federal poverty level are eligible for financial assistance.

The federal government updates this information: https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty- guidelines   

How do I apply for financial assistance?

Complete a Financial Assistance Application linked below, or ask a Samaritan staff member for a paper copy as they are available upon request. Submit the complete application and proof of household income for the last four weeks to the address listed below for the Financial Counseling Unit at Samaritan Medical Center.

If you are uninsured, you will be required to be screened for eligibility through the NYS Marketplace with a Financial Counselor prior to being approved.

How will I know if I was approved for the discount?

The Financial Counselor will send you a letter within 30 days after the application is processed and required proof of income is received advising you if you have been approved and the amount of the discount.

What if my application is denied?

If your application is denied, the hospital will tell you why in writing within 30 days and will provide you with a way to appeal if you disagree with the decision.

Need help?

If you have any questions regarding the application, or need help filling it out, please contact our Financial Assistance Counselors at 315-785-4308 or by emailing [email protected]. 

Please understand that Samaritan works with several private physician offices for services and they develop their own financial assistance policies and are not linked to Samaritan directly.

Download the Financial Assistance Program Application. Adobe Acrobat is needed to view and save this application. Full copies of this application can be provided to you at no cost by reaching out to our Financial Counseling Unit.

All information will remain confidential and will only be used to help guide our process.