Financial Assistance Program
At Mount Sinai South Nassau, we provide care without regard to source of payment. If you do not have insurance or another way to pay, please call our Financial Assistance counselors at (516) 632-3979. Fully staffed with bilingual employees, these caring professionals can help you see if you qualify for:
- Medicaid
- Subsidized health insurance through NY State of Health
- Unsubsidized health insurance through NY State of Health
- Free care
- A fee reduction based on the hospital's Financial Assistance Program
Mount Sinai South Nassau Financial Assistance Policy — Plain Language Summary
The Mount Sinai South Nassau Financial Assistance Policy (FAP) provides Eligible Patients (as defined below) with partially or full discounted emergency or other medically necessary health care services provided by Mount Sinai South Nassau or Oceanside Counseling Center (together, hereinafter referred to as the HOSPITAL). Patients seeking Financial Assistance must apply for the program, as described below.
Definitions
Eligible Services — Emergency or other medically necessary health care services provided by the HOSPITAL and billed by the HOSPITAL. Patients who reside in New York State who need emergency services can receive care and qualify for a discount if they meet certain income levels. Patients who reside in Nassau County, Suffolk County and the five counties comprising New York City can qualify for a discount on non-emergency, medically necessary services at the HOSPITAL if they meet certain income levels. The FAP only applies to services billed by the HOSPITAL. Other services that are separately billed by other providers, such as non-employed physicians or outside laboratories, are not eligible under the FAP.
Eligible Patients — Patients receiving Eligible Services, who submit a complete Financial Assistance Application (including related documentation/information), and who are determined eligible for Financial Assistance by the HOSPITAL.
How to Apply
The FAP and the related application form may be obtained at no cost as follows:
- In person at the HOSPITAL’s main registration area, emergency room registration area, outpatient department, Financial Assistance Department or at the Oceanside Counseling Center
- Via telephone, request an application be mailed to you by calling the Financial Assistance Department at (516) 632-3979
- By mail, send a request to Mount Sinai South Nassau, Financial Assistance Department, One Healthy Way, Oceanside, NY 11572
- Download the documents from the HOSPITAL’s website below
There is no charge to download these materials, and patients are not required to create an account or provide personally identifiable information.
Mail or deliver completed applications (with all
documentation/information specified in the application instructions)
to: Mount Sinai South Nassau, Financial Assistance Department, One Healthy Way, Oceanside,
NY 11572.
Determination of Financial Assistance Eligibility
Generally, eligible patients are eligible for financial assistance, using a sliding scale, when their family income is at or below 300% of the federal government’s Federal Poverty Guidelines
(FPG). Eligibility for Financial Assistance means that eligible persons will have their eligible services covered fully or partially, and they will not be billed more than "Amounts Generally
Billed"(AGB) to Medicare.Financial Assistance levels, based solely on family income and FPG, are:
Family Income at 0 to 100% of FPG
|
Patient responsible for Nominal Payment Rate only |
Family Income at 101% to 400% of FPG |
101% to 400% of FPG
Partial Financial Assistance; AGB is maximum amount billable to the patient |
Note: Other criteria beyond FPG are also considered (i.e., availability of cash or other assets that may be converted to cash, and excess monthly net income relative to monthly household expenditures), which may result in exceptions to the preceding. If no family income is reported, information will be required as to how daily needs are met. The Financial Assistance Department reviews submitted applications that are complete, and determines financial assistance eligibility in accordance with the HOSPITAL’s Financial Assistance Policy. Incomplete applications are not considered, but applicants are notified and given an opportunity to furnish the missing documentation/information.
This Plain Language Summary, the FAP, and the FAP application form are also available in Spanish upon request from the Financial Assistance Department, One Healthy Way Oceanside, NY 11572, and on our website.
Further Information/Help
For help, assistance, or questions regarding the FAP, please visit or call the Financial Assistance Department at (516) 632-3979, Monday through Friday from 8:30am-5pm.
Mount Sinai South Nassau Financial Assistance Policy Documents
Financial Assistance Policy English (PDF)
Financial Assistance Policy Spanish (PDF)
Financial Assistance Policy Summary English (PDF)
Financial Assistance Policy Summary Spanish (PDF)
Billing and Collections Policy for Self-Pay English (PDF)
Billing and Collections Policy for Self-Pay Spanish (PDF)
Financial Assistance Application English (PDF)
Financial Assistance Application Spanish (PDF)
List of Providers that Are Covered / Not Covered Under the Financial Assistance Policy