The North Star Health Alliance (NSHA), which includes Carthage Area Hospital (CAH), Claxton-Hepburn Medical Campus, Claxton-Hepburn Medical Center, North Country Orthopaedic Group (NCOG), and affiliated entities, is committed to ensuring all individuals receive medically necessary care without financial barriers, regardless of ability to pay.
Our Promise to You
NSHA provides emergency and medically necessary healthcare—including hospital, clinic, and physician services—without discrimination. We never deny essential care due to unpaid balances or lack of insurance. If you qualify, we offer free or discounted care so you can focus on healing, not hospital bills.
Who qualifies for financial assistance?
You may qualify for financial assistance if you:
- Are uninsured (no health coverage) and your gross household income is at or below 400% of the Federal Poverty Level (FPL).
- Are underinsured (insurance doesn’t sufficiently cover your costs and out-of-pocket expenses exceed 10% of your annual income) and your gross household income is at or below 400% of the Federal Poverty Level (FPL).
| Federal Poverty Levels (2025): | ||||
| Household
Size |
100% | 200% | 300% | 400% |
| 1 | $15,650.00 | $31,300.00 | $46,950.00 | $62,600.00 |
| 2 | $21,150.00 | $42,300.00 | $63,450.00 | $84,600.00 |
| 3 | $26,650.00 | $53,300.00 | $79,950.00 | $106,600.00 |
| 4 | $32,150.00 | $64,300.00 | $96,450.00 | $128,600.00 |
| 5 | $37,650.00 | $75,300.00 | $112,950.00 | $150,600.00 |
| 6 | $43,150.00 | $86,300.00 | $129,450.00 | $172,600.00 |
| 7 | $48,650.00 | $97,300.00 | $145,950.00 | $194,600.00 |
| Add $5,500 for each additional person. | ||||
Updated annually: https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines
Minimum Discount Rates:
If you qualify for financial assistance, charges will be reduced according to your income on a sliding fee scale:
| Income Level | Payment |
| Below 200% FPL | Waive all charges |
| 200%-300% FPL | Uninsured patients: Sliding scale up to 10% of the amount that would have been paid for the service(s) by Medicaid.
Under insured patients: Up to a maximum of 10% of the amount that would have been paid pursuant to such patient’s insurance cost sharing. |
| 301%-400% FPL | Uninsured patients: Sliding scale up to 20% of the amount that would have been paid for the service(s) by Medicaid.
Under Insured Patients: Up to a maximum of 20% of the amount that would have been paid pursuant to such patient’s insurance cost sharing. |
How do I Apply?
- Pick up an application at any North Star Registration Desk, ER, or Patient Financial Services Office, Online:
The patient or guardian fills out a one page application providing the following information:
-
- List of all household members
- Income verification
- Last four pay stubs (2 if paid bi-weekly)
- Last two bank statement
- Last four unemployment/workman’s comp info
- Social Security, disability, or retirement award letter(s)
- Where no type of income documentation is available the self-assestation form may be used
- Return the completed application and required documentation within 30 days of receiving it to the NSHA facility where you received or will receive care.
| Carthage Area Hospital | Claxton-Hepburn Medical Center | Claxton-Hepburn Medical Campus | North Country Orthopaedic Group |
| 1000 West Street
Carthage, NY 13619 |
214 King Street, Suite B
Ogdensburg, NY 13619 |
214 King Street. Suite A
Ogdensburg, NY 13619 |
1571 Washington St, Suite 201
Watertown, NY 13601 |
Actions in the Event of Non-Payment
NSHA will make reasonable efforts to determine whether a patient is eligible for financial assistance before engaging in any extraordinary collection actions (ECA).
These efforts include:
- Providing the patient with a copy of the FAP and Plain Language Summary.
- Providing at least one written notice and one oral attempt to inform the patient about the FAP and how to apply.
- Allowing a minimum of 120 days from the first post-discharge billing statement before initiating ECA.
Extraordinary collection actions may include reporting to credit agencies, placing liens, or pursuing legal action, and will only occur after these steps are completed.
Where do I find the FAP Application?
- Patients or guardians can request a copy of the FAP form in person at their point of care hospital (Carthage Area Hospital, Claxton-Hepburn Medical Center, Claxton-Hepburn Medical Campus, or North Country Orthopaedic Group) at the following locations:
- Any reception area
- ER Dept
- Patient Financial Dept
- Patients or guardians can also request a copy of the FAP form:
- By calling the patient accounting office: 315-565-7580
- By calling the number on your billing statement: 855-339-2795
- Downloading from our Website
Language Access & Translations
In accordance with federal law, NSHA provides free translation services for patients with Limited English Proficiency (LEP).
The Financial Assistance Policy, Plain Language Summary, and application form are available in Spanish and French, additional languages upon request.
Patients can request translated copies in person, by phone, or online.
Need More Information?
The Patient Financial Services Office can also Mail, Email or Fax a copy of the FAP upon request.