Patient Financial Assistance Policy
Mass. Eye and Ear maintains a patient financial assistance program intended to assist low-income patients who do not have the ability to pay for their health care services.
• Assists patients to apply for federal and/or state health insurance that may cover all or some of the cost of their medical care.
-Mass. Eye and Ear provides this assistance for both residents and non-residents
of Massachusetts; however, there may not be coverage for Massachusetts health
care services through an out-of state program.
• Partially or fully waives patient financial obligations (including copayments and deductibles) for health care services provided by Mass. Eye and Ear for qualifying low-income patients with:
-No health insurance who are deemed ineligible for federal or state health
insurance programs, and
-Federal, state or commercial health insurance.
Mass. Eye and Ear will only waive patient financial obligations for patients who have:
• Completed the Financial Assistance Application and provided necessary supporting documentation, and
•Been determined by Mass. Eye and Ear to be eligible for financial assistance in accordance with the Mass. Eye and Ear Patient Financial Assistance Policy.
Financial assistance will not be provided for medically unnecessary services, such as cosmetic surgery, most contact lenses, or for most hearing aids.
How to Apply for Patient Financial Assistance
Patients may apply for financial assistance by:
•Completing, signing and dating the Financial Assistance Application,
•Attaching copies of supporting documentation to the Financial Assistance Application, and
•Mailing or delivering the Financial Assistance Application and supporting documentation to the following address:
Massachusetts Eye and Ear Infirmary
243 Charles Street
Boston, MA 02114-3096
Attention: Financial Counselors
Click on this link to access the Financial Assistance Application: Financial Assistance Application. You may fill out the application using a computer, and then print out and sign the completed application, or you may print out the blank application and fill it in by hand. A Financial Assistance Application Checklist is available to help you gather supporting documentation for your Financial Assistance Application. Click on this link to access the Financial Assistance Application Checklist: Financial Assistance Application Checklist.
Financial Assistance Applications and Checklists are also available in the Financial Counselor’s area on the lobby floor of the hospital’s main campus located at 243 Charles Street, Boston, Massachusetts 02114, and may also be requested by telephone by calling a Hospital Financial Counselor at 617-573-3073, 617-573-4098 or 617-573-6882 from Monday through Friday between 8:00 a.m. to 4:30 p.m.
Discounts and Payment Plans
For patients who do not have insurance coverage for the services that they receive and are ineligible for financial assistance, Mass. Eye and Ear also offers a 20% prompt payment discount for payment received in full within 10 days of treatment.
Mass. Eye and Ear may also establish a payment plan for amounts due from a patient.
Page updated: 2/16/12