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Financial Assistance FAQs

Spanish Version

What should I do first?

Please contact us if you need assistance paying for your medical bill, there are several financial assistance programs available that we can assist with. Please call 518.243.1695 or 1.877.456.4557 for more information.

What is Financial Assistance?

Financial Assistance is a program that can reduce or eliminate your Ellis Medicine bill and is based on an approval process. How much it is reduced/eliminated is based on established guidelines that include: income level, medical situation, and other indicators of inability to pay. To learn more or apply please ask to speak to a Financial Advocate.

Financial assistance program(s) you may be eligible for:

  • Medical Insurance Assistance Program
  • Medicaid
  • Essential Health Plan
  • Financial Assistance  [Financial Assistance Application]
  • Marketplace Exchange Plan
  • Self-pay discount

Who qualifies for financial assistance?

Financial Assistance is available for patients with limited incomes and who are uninsured or underinsured.

Everyone who needs emergency services will receive care. Financial assistance is available for residents of New York State who meet the income limits and/or other criteria as defined in the Financial Assistance Policy 

Everyone who can provide documentation of NY State residence can receive financial assistance for non-emergency, medically necessary services at Ellis Medicine if they meet the income limits.

To determine your eligibility for Financial Assistance you must complete a Financial Assistance Application.   It is important for you to know that you cannot be denied medically-necessary care because you need financial assistance.

Regardless of immigration status, if you reside in NY State, you can apply for financial assistance.  

What are the income limits for Financial Assistance?

Use the 2016 Federal Poverty Level (FPL) scale below to determine your where your family size and income place you in the percentages across the top.   You can then take the percentage and apply that to The Financial Assistance Income Tiers as a guide to determine what assistance you may be eligible for.   (For example: If you are a family of 3 in the household and have a combined income of $37,980, this places your household between the 150-200% range.  In the next table (Financial Assistance Tiers) you could quality under the 0-200%, meaning your full balance would be covered by financial assistance) 

2016 FPL Scale

 

Family Size 100% 150% 200% 250% 300% 400%
1 $11,880 $17,820 $23,760 $29,700 $35,640 $47,520
2 $16,020 $24,030 $32,040 $40,040 $48,060 $64,080
3 $20,160 $30,240 $40,320 $50,400 $60,480 $80,360
4 $24,300 $36,450 $48,600 $60,750 $72,900 $97,000
5 $28,440 $42,660 $56,880 $71,100 $85,320 $113,640
6 $32,580 $38,870 $65,160 $81,450 $97,740 $130,280
7 $36,730 $55,095 $73,460 $91,825 $110,190 $146,920
8 $40,890 $61,335 $81,780 $102,225 $122,670 $160,360

Financial Assistance Income Tiers

Income Tier $ of FPL Financial Assistance Award of Medicare-Equivalent Rate Dental Financial Assistance Award (Highest Vol. Payer Rates)
1 0-200% 100% 100%
2 201-250% 50% 50%
3 251-300% 0% 0%
4* 0-300% 50% 50%
*For balance after insurance only, a 50% discount will be applied to remaining patient obligation.
 

What if I do not meet the income limits for Financial Assistance?

If you cannot pay your bill, Ellis Medicine can work with you to set-up a payment plan or assist in identifying alternative financial assistance programs. Please call 518.243.1500 or 1.877.456.4557 to speak with a Customer Service representative.
 

What information do I need to apply for Financial Assistance?

  • Picture ID
  • A bill indicating his/her address
  • Pay stub
  • If you cannot provide any of these, you may still be able to apply for financial assistance

How do I apply for the Ellis Medicine Financial Assistance Program?

Complete a Financial Assistance Application [Spanish Application] or Call our Financial Advocates at 518.243.1695, or visit the Financial Advocate office at Ellis Hospital in the Admitting/Patient Registration area, Monday through Friday during normal business hours.  Someone can assist you with the Application, information needed or any questions you may have.
 
If you do not speak English, someone will help you in your own language.
 

How does the process work?

Return your completed application form and necessary documents to an Ellis Financial Advocate or mail to:
Ellis Medicine
Patient Financial Services – Mail Code 1935
ATTN: Financial Assistance
1101 Nott Street
Schenectady, NY 12308
 
Once your application is reviewed, you will be notified of three possible results:
  • We need more information from you to complete your application.
  • Financial Assistance was approved at one of the tiers.
  • You did not qualify for Financial Assistance. 
If you are denied Financial Assistance, you can appeal by submitting a letter to the hospital Patient Services Financial Director explaining why the determination should be reconsidered. Please include any additional and appropriate supporting documents at this time. 
 
Such letters can be mailed to:
 
Ellis Medicine
Patient Financial Services – Mail Code 1935
ATTN: Financial Assistance
1101 Nott Street
Schenectady, NY 12308
 

What services are covered?

  • All medically necessary services provided by Ellis Medicine are covered by financial assistance. This includes outpatient services, emergency care and inpatient admissions.
  • The Financial Assistance Program does not honor any applications for admission(s) to our Skilled Nursing Facility and non-emergent elective services, such as cosmetic or dental procedure and, some bariatric procedures.
  • Charges from private doctors that Ellis Medicine does not bill for who provide services in the hospital are not covered.  A list of these provides can be found on our website.  You should talk with your private doctor(s) to see if they offer a discount or payment plan.

Services Not Billed by Hospital

During your hospital stay, you may receive treatment from providers who will bill separately for their services. We will give your insurance information to these providers. Please contact these providers directly with any questions about your bill. Examples of separately billed services: your physicians/surgeon, other consulting physician fees, emergency department physicians, radiologists, anesthesiologists, pathologist, cardiologist, neurologist. You should talk to private doctors to see if they offer a discount or payment plan.
 

What is the Average Out-of-Pocket Cost for Someone Without Insurance?

Costs will vary depending on the health care service rendered and the setting in which the care is delivered (e.g., hospital, doctor's office). For example, the average out-of-pocket expense for an uninsured patient for a visit to the emergency room vs. a doctor's office is generally as follows:
 
  Emergency Department Visit Doctor Office Visit
Uninsured Patient Average Out-of-Pocket Expense $250.00 $70.00
 
Notes:
  • Additional charges (discounted) will apply for any ancillary services, i.e. lab or x-ray. New York State Surcharge of 9.63% also applies to all patient expenses and will be added to your bill
  • The amounts above are  only an example of an average cost for a typical emergency department and doctor office visit. It is not a quote for the cost of any service rendered at Ellis Medicine.  
  • The grid below states the expected payment at the time of service and will be applied to your account as a partial payment on services received.
Service Self-Pay Expected Payment at Time of Service
ED Technical/Professional $250.00 per Visit as initial down payment and billed for remaining balance, net of 50% discount applied to total charges for Visit
Emergent Technical/Professional $150.00 per Visit as initial down payment and billed for remaining balance, net of 50% discount applied to total charges for Visit
Outpatient / Inpatient 50% Discount applied to total charges incurred 
Clinic / Professional 50% Discount applied to total charges incurred