Financial Assistance Policy - Plain Language Summary

The Financial Assistance Policy ("FAP") of JFK Health System, Inc., which includes JFK Medical Center and Johnson Rehabilitation Institute (collectively, "JFK") exists to provide financial assistance to patients who have healthcare needs and are uninsured, underinsured, ineligible for other government assistance, or are otherwise unable to pay for emergency or other medically necessary healthcare services based on their individual financial situation. Patients seeking financial assistance must apply for the program, which is summarized herein.

Eligible Services: Financial assistance is only available for emergency or other medically necessary healthcare services. Not all services provided within the JFK Medical Center or Johnson Rehabilitation Institute facilities are covered under the FAP. Certain services which are separately billed by other providers may not be covered. Please refer to Appendix A of JFK's FAP for a list of providers that provide healthcare services within those facilities and whether or not they are covered under the FAP.

Eligible Patients: Patients receiving eligible services, who satisfy the eligibility criteria and submit a completed financial assistance application including all required documentation.

How to Apply: The FAP and FAP Application may be obtained/completed/submitted as follows:

Financial Assistance Eligibility: Generally, uninsured and underinsured patients may be eligible for full financial assistance when their family gross income is less than or equal to 200% of the Federal Poverty Level ("FPL"). Additionally, all uninsured patients are eligible for partial financial assistance.

Financial assistance levels, based solely on FPL are:

Note: Other criteria beyond FPL may also be considered (i.e. asset thresholds, residency status, insurance status), which may result in exceptions to the preceding. JFK's Financial Representatives review submitted applications, and determine financial assistance eligibility in accordance with the FAP.

Any individual determined to be eligible for financial assistance under the FAP will not be charged more than Amounts Generally Billed ("AGB") for emergency or other medically necessary healthcare services. Any FAP-eligible individual will always be charged the lesser of AGB or any discount available under the FAP.

Availability of Translations: The FAP, Application and PLS are available in English and in the primary language of populations with limited proficiency in English ("LEP") that constitutes the lesser of 1,000 individuals or 5% of the community served by JFK.

For help, assistance or questions please call the Business Office at (732) 321-7566.