Financial Assistance Program

Samaritan is proud of our mission to provide high-quality, compassionate healthcare services to meet the needs of our civilian and military community. Samaritan Medical Center and Samaritan Family Health Centers render medical care to all persons in need of care, regardless of their ability to pay. Samaritan’s Patient Financial Assistance Program may help those who are unable to pay all their medical bills if they qualify.

You may qualify if:

• You do not have health insurance, and you earn up to 400% of Federal Poverty Level (see amounts on application as they vary by household size)
• You are “underinsured” meaning you have spent more than 10% of your annual income on out-of-pocket medical expenses.

Download the Financial Assistance Program Application. Adobe Acrobat is needed to view and save this application.

If you are worried that you will be unable to pay your Samaritan medical bill in full, please complete the New York State standard on-line application, and return it with all required documentation to the address listed below.

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

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