Title	Size
APPENDIX A - English (PDF)	161.00 KB
APPENDIX A - English (TXT)	4.52 KB
APPENDIX A - Polish (PDF)	174.72 KB
APPENDIX A - Polish (TXT)	4.63 KB
APPENDIX A - Spanish (PDF)	173.16 KB
APPENDIX A - Spanish (TXT)	4.62 KB
APPENDIX B - English (PDF)	507.23 KB
APPENDIX B - English (TXT)	19.89 KB
APPENDIX B - Polish (PDF)	586.45 KB
APPENDIX B - Polish (TXT)	21.02 KB
APPENDIX B - Spanish (PDF)	397.96 KB
APPENDIX B - Spanish (TXT)	21.09 KB
Financial Assistance Policy - English (PDF)	1,239.42 KB
Financial Assistance Policy - English (TXT)	34.61 KB
Financial Assistance Policy for Language Line Translation - Polish (PDF)	770.92 KB
Financial Assistance Policy for Language Line Translation - Polish (TXT)	34.25 KB
Financial Assistance Policy for Language Line Translation - Spanish (PDF)	931.35 KB
Financial Assistance Policy for Language Line Translation - Spanish (TXT)	38.29 KB
Plain Language Summary - English (PDF)	153.78 KB
Plain Language Summary - English (TXT)	5.84 KB
Plain Language Summary - Polish (PDF)	237.71 KB
Plain Language Summary - Polish (TXT)	6.41 KB
Plain Language Summary - Spanish (PDF)	151.55 KB
Plain Language Summary - Spanish (TXT)	6.88 KB

Peconic Bay Medical Center provides charitable assistance for people in need.

Those seeking charitable assistance must meet certain income guidelines. In order to be considered for the program, you must be uninsured or underinsured (benefits exhausted) and have a family income at or below 500% of the Federal Poverty Level. Eligibility and assistance is based on family income and size.

To determine eligibility and the appropriate level of financial assistance, the patient must submit documents verifying family size and income.

Such documents may include the following:

The applicant's prior year's W-2 form
Current pay stubs
Written verification of wages from your employer
Unemployment letter
Social Security Check
Birth Certificate
Marriage Certificate
Death Certificate
Separation Papers
Social Security Cards
Additional documents may be requested.

This documentation should be forwarded to:

Peconic Bay Medical Center Financial Assistance Coordinator 1 Heroes Way (Formerly 1300 Roanoke Avenue) Riverhead, NY 11901

If you have any further questions, please contact Peconic Bay's Financial Aid Representative at (631) 548-6099, Monday-Friday, 9 am - 5 pm

Si tiene alguna pregunta referente a su factura y necesita de los servicios de interprete en espanol, por favor llame al (631) 548-6758 para obtener ayuda.