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. If you are eligible for FAP, you may not be charged more than the Amounts Generally Billed for emergency or other Medically necessary care.

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 (English) or Financial Assistance Program Application (Spanish). This application is available in various primary languages through the New York State Department of Health. Applicants seeking financial assistance for care received at Samaritan Medical Center in Watertown, New York must mail the completed application and supporting documents to Samaritan Medical Center 104 Paddock Street Watertown, NY 13601 Attn: Financial Counseling Team.

Paper copies of the Samaritan Medical Center Financial Assistance Policy, Application, and Plain Language Summary are available in other languages upon request by contacting the Financial Counselors at 315-785-4308.

Children’s Miracle Network of Northern New York Direct Family Assistance Program

As a Children’s Miracle Network hospital, Samaritan offers a Direct Family Assistance Program. This provides financial assistance for expenses related to a child’s serious medical condition. This may include reimbursement of travel costs for medical care away from home, medical bills, prescriptions, copays and medically-necessary equipment not covered by insurance. This program assists children through age 18 (or 21 for dependents and students) who reside in Jefferson, Lewis or St. Lawrence County, regardless of where they receive medical care.

To learn more or request an application, please contact us at 315-785-4053 or [email protected]  To pre-apply, click here.

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