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Charity Care Programs and Facilitated Enrollment
Financial Assistance Summary

Kaleida Health recognizes that there are times when patients in need of care will have difficulty paying for the services provided. Kaleida Health’s Charity Care Program provides discounts to qualifying individuals based on your income and assets. In addition, we can help you apply for free or low-cost insurance if you qualify. Just contact our Charity Care/Facilitated Enroller Hotline at (716) 859-8979 for free, confidential assistance.

Who qualifies for a discount?

  • Financial Assistance is available for low income, uninsured individuals and those with insurance who meet the income/asset guidelines.
  • You cannot be denied medically necessary care because you need financial assistance.
  • You may be eligible for our charity care program regardless of immigration status

The amount of the discount varies based on your income and the size of your family. Income limits are based on 2013 federal poverty guidelines

Kaleida Health is committed to providing quality health care services at a reduced charge to eligible persons who cannot afford to pay for these services.  Charity care is available to patients of families based on the following income and family size guidelines as determined by Federal poverty regulations as published by the New York State Department of Health and Human Services.

Size of Family

Family Income Less Than:

 

1

23,340

29,175

35,010

40,845

46,680

2

31,460

39,325

47,190

55,055

62,920

3

39,580

49,475

59,370

69,265

79,160

4

47,700

59,625

71,550

83,475

95,400

5

55,820

69,775

83,730

97,685

111,640

6

63,940

79,925

95,910

111,895

127,880

7

72,060

90,075

108,090

126,105

144,120

8

80,180

100,225

120,270

140,315

160,360

Each Add’tl

8,120

10,150

12,180

14,210

16,240

Discount on Charges

100%

90%

75%

60%

50%

Patient Share

0

 

10%

 

25%

 

40%

 

50%

 

Revised 2/2014/SRW

What if I do not meet the income limits?

If you do not meet the income guidelines under the charity care program, Kaleida Health offers a self pay discount and payment plan to all patients.

Can someone explain the self pay discount?

Yes, confidential help is available. Call (716) 859-7200 for information regarding a self pay discount.

Can someone explain the charity care program?

Yes, confidential help is available. Call (716) 859-8979.

Can someone help me apply for charity care assistance?

Yes, confidential help is available. Call (716) 859-8979.

If you do not speak English, someone will help you in your own language.

  • The Facilitated Enroller can tell you if you qualify for free or low-cost insurance, such as Medicaid, Child Health Plus and Family Health Plus.
  • If the Facilitated Enroller finds that you don’t qualify for low-cost insurance, they will help you apply for a charity care discount.
  • The Facilitated Enroller will help you fill out all the forms and tell you what documents you need to bring.

What do you consider assets?

Kaleida Health takes into consideration information from bank statements. We do not include retirement funds, education funds or cars used regularly by you or immediate family members.

What do I need to apply for Charity Care discount?

For Charity Care Assistance, we require four current pay stubs, as well as bank statements not including retirement plans, annuities, etc.

What services are covered?

All medically necessary services provided by Kaleida Health are covered by the Charity Care Program  This includes outpatient services, emergency care, inpatient admissions and nursing home care Charges from private doctors who provide services in the hospital may not be covered. You should talk to the private doctor to see if they offer a discount or payment plan.

How much do I have to pay?

Our Charity Care representative will give you the details about your specific discount(s) once your application is processed.

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 application to Kaleida Health.

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

Kaleida Health will send you a letter within 30 days after completion and submission of your application telling you if you have been approved and the level of discount granted.

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.