Bertrand Chaffee Hospital Financial Assistance Program

The Bertrand Chaffee Hospital Financial Assistance Program is designed to assist patients who have been treated at Bertrand Chaffee Hospital but are unable to pay for the medical services they received because of a financial hardship. Our program is based on the Federal Poverty Guidelines and a sliding fee scale.

Who is eligible?

All patients either insured, underinsured or uninsured.

Who is not eligible?

Persons who exceed the income guidelines (current Federal Poverty Guidelines) or who are not US citizens, and or no social security number.

How do I apply?

All persons interested in our financial aid program may contact us at 716-592-2871 ext. 1207 or visit our website at

Does Bertrand Chaffee Hospital offer payment plans?

Yes, we offer monthly payment plans. Please contact our office to arrange a payment plan.

Financial Assistance Summary/Application

Financial Assistance Form/Spanish

Financial Assistance Policy & Procedure

2024 Federal Poverty Guidelines

Providers covered under Financial Aid Assistance

Our credit/collections office is open Monday-Friday from 7am-3:30pm. The phone number is 716-592-2871 ext. 1319. We accept cash, check, and credit card payments from Visa, Mastercard and Discover via telephone and website.

To obtain a paper copy of our Financial Assistance Application via mail, please contact 716-592-2871 ext. 1319.