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Financial Counseling/Assistance

Financial Assistance

You may apply for financial assistance by requesting assistance from the Financial Counselor’s office located in Patient Access in the Main Lobby or by contacting
781-624-4329. Other programs include MassHealth and Medical Hardship.
Please call 781-624-4329 for eligibility information and verification of requirements.

This financial assistance program does not include physicians’ fees. Physicians will bill you separately for their services. Along with your private physician, services may be provided to you and billed by anesthesiologists, pathologists, radiologists, and other specialists.

Notice of Hospital Financial Assistance

Availability

Patients may apply for financial assistance for medically necessary service. Non-medically necessary services, such as elective cosmetic surgery and the private room differential, are excluded from consideration for financial assistance.

Financial Criteria

You may be eligible for financial assistance through a public assistance program, including Commonwealth Care, MassHealth, and Health Safety Net.

Eligibility for these programs is determined by comparing your family size and family income with the MassHealth Income Standards and Federal Poverty Guidelines — see the table below:

2013 MassHealth Income Standards and Federal Poverty Guidelines
(MassHealth and 100%-135% Federal Poverty Levels)  

 

100%

 100%

  120% 133%  135% 

Size of Family Unit

Federal Standard

Seniors (Standard;

Essential;
Basic, DMH Services		 Medicare Buy-in (QMB) Parents Caretakers and Disabled Adults (Standard) Medicare Buy-in, Full Low Income Subsidy for Medicare Prescription Drug Coverage
1 $11,490 $11,496 $13,788 $15,516 $15,516
2 $15,510 $15,516 $18,720 $20,640 $20,940
3 $19,530 $19,536 --- $25,980 ---
4 $23,550 $23,556 --- $31,332 ---
5 $27,570 $27,576 --- $36,672 ---
6 $31,590 $31,596 --- $42,024 ---
7 $35,610 $35,616 --- $47,364 ---
8 $39,630 $39,636 --- $52,716 ---
For each additional person, add +$4,020 $4,020 --- $5,352 ---

(150%-400% Federal Poverty Levels)   

 

  150%  200%  250%  300%  400%

Size of Family Unit

 

 

 

 

Children
1-18 (Standard), Partial Low income Subsidy for Medicare Prescription Drug Coverage
Pregnant Women and infants (Standard), HIV + (Family Assistance). and Full HSN
 
 
 
 
 
Upper Limit for  MassHealth and Breast and Cervical Cancer Programs
 
 
 
 
 
 Family Assisstance, Insurance Partnership (under 300%), Commonwealth Care
 
 
 
 
 
Partial HSN, CMSP, and Medical Security Plan
 
 
 
 
 
 
1 $17,224 $22,980 $28,728 $34,476 $45,960
2 $23,268 $31,020  $38,784

$46,536

$62,040
3

$29,304

$39,060

 $48,828

$58,596

$78,120
4

$35,328

$47,100

$58,884

$70,656

$94,200
5

$41,364

 $55,140

$68,928

$82,716

$110,280
6

$47,388

$63,180

$78,984

$94,776

$126,360
7

$53,424

$71,220

$89,028

$106,836

$142,440
8

$59,448

$79,260

$99,084

$118,896

$158,520
For each additional person, add

$6,036

$8,040

$10,056

$12,060

$16,080

DG-FPL (Rev. 03/12)

 

 

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