Hospital for Special Surgery: Apply Before Your Care, and Approval Lasts Two Years

Apply before the date

HSS’s policy says you may request financial assistance at any time: before, during or after care. For scheduled care, use the first option. HSS commits to a decision within 30 days of a complete application, and an approval lasts two years, covering later visits too.

Who the policy reaches

HSS does not limit its program to a primary service area. Its financial criteria cover U.S. residents, including students, with gross annual income up to seven times the federal poverty guidelines: $111,720 for one person in HSS’s 2026 table.

That is wider than state law requires. The law requires assistance for emergency care to any New York State resident, and for non-emergency care to residents of the hospital’s primary service area. Under HSS’s policy, living in New Jersey or Ohio does not count against you.

Two groups go through the Special Access Program instead, which is open only to patients not expected to need services outside HSS:

• Residents of other countries, on a referral from a physician in the HSS Physician Hospital Organization that HSS approves.
• Insured patients whose plan does not cover HSS at all, with no out-of-network benefit. They qualify when the care is not reasonably available closer to home, or through an approved referral.

An approval through that program covers only that episode of care.

Check the physician list first

HSS’s own billing page says one procedure or visit can produce bills from various departments, and its financial assistance covers the hospital and only some of its physicians. The document that settles which ones is Schedule A.

Schedule A names physicians one by one, each marked yes or no for whether HSS financial assistance applies. The posted version is marked current as of August 31, 2026, and the policy says it is reviewed at least quarterly.

Before the date, look up every name on your paperwork: the physician, and anyone else you are told will bill, such as anesthesia. What one visit can generate.

A yes means your approval reaches that bill. A no means it does not, and that practice decides on its own terms. Ask it before the date:

“HSS’s Schedule A lists this physician as not covered by its financial assistance policy. What does the practice offer a patient who cannot pay?”

Before the number

Do three things before you pay any HSS bill, in this order.

Ask for an itemized bill. A line-by-line statement shows what was billed, by which entity, and on which date. Duplicates and charges for things that did not happen show up there, not in a total.

Check that insurance processed it. If you are insured, match the bill against your plan’s explanation of benefits. Until the plan has decided the claim, the amount on the bill can still change.

Apply, even if you are insured. HSS’s policy counts patients with out-of-pocket costs under coverage that includes HSS as underinsured. State law adds its own test: out-of-pocket medical costs over 12 months above 10% of gross income. Underinsured, defined.

HSS’s summary says you may disregard any bills while your application is being considered. Write the date you applied on everything you keep.

The floor that applies regardless

HSS’s full policy carries a revision date of October 10, 2024, ten days before New York’s amended law took effect. The state floor binds whatever the posted policy says:

• At or below 200% of the federal poverty level: nothing out of pocket for medically necessary care
• 201% to 300%: no more than 10% of the Medicaid rate; 301% to 400%: no more than 20%
• No asset test, immigration status not considered, a written decision in 30 days, no lawsuit below 400%, payment plans capped at 5% of monthly income and 2% interest, 180 days before collections

HSS’s own terms sit above that floor in places. Its summary, effective January 2026, describes free care at or below 500% of the poverty level (for insured patients, a share reduced to zero) and a 50% discount from 501% to 700%. Its payment plans carry no interest.

If the policy is not applied as written, HSS directs complaints to its Corporate Compliance Officer, published as 212.774.2398. Outside the hospital: the Attorney General’s Health Care Bureau Helpline, 800-428-9071.