Hospital · Cuba, NY
Cuba Memorial Hospital, Inc.
Free care to 200% of the federal poverty level.
FPL LEVEL 200% 300% 400% 1 $30,120 $45,180 $60,240 2 $40,880 $61,320 $81,760 3 $51,640 $77,460 $103,280 4 $62,400 $93,600 $124,800 5 $73,160 $109,740 $149,320 6 $83,920 $125,880 $167,840 7 $94,680 $142,020 $189,360 8 $105,440 $158,160 $210,880 Each add’l person add: $10,760 $16,140 $21,520 Discount on Charges 100% 90% 80% Patient Share 0% 10% 20% Form #:
What the policy says
Quoted from the hospital’s own documents · read by WaiveDocuments to includeMatchedProof of income; tax return; pay stubs; medicaid denial“Cuba Memorial Hospital will require a completed Financial Assistance application and proof of income such as a tax return or pay stubs. We may also request a Medicaid denial letter but not required.”[PDF] Financial Assistance Summary - Cuba Memorial Hospital · read by Waive · cubamemorialhospital.com · retrieved Oct 11, 2026
DecisionMatched30 days“You will receive a letter from Cuba Memorial Hospital (usually within 30 days after completion and submission of documentation) telling you if you have been approved and the level of discount received”[PDF] Financial Assistance Summary - Cuba Memorial Hospital · read by Waive · cubamemorialhospital.com · retrieved Oct 11, 2026
What Tender found
Allegany County · CMS · Tender’s own checksWebsiteUnverifiedNo verified websiteTender checks the price file only on a verified website
Price fileUncheckedWebsite not verified · not checkedTender’s own check · not yet checked · logged, not quoted
CMS actionNoneNo CMS penalty on fileCMS price transparency enforcement list · no notice names this hospital