Financial Assistance for Uninsured Patients
If you have no health insurance or third-party payer source to help pay your hospital bill, we may be able to help.- Payment Options
- FAQs
- Income Eligibility Guidelines
- Government Programs
- Charity Policy
- Form: Statement of Financial Condition
- Uninsured Patient Discounts: Uninsured patients receive a 40 percent discount on hospital inpatient charges and a 25 percent discount on outpatient services. An itemized bill reflecting your discount will be mailed to you five to seven days after the date you received service or your date of discharge from the hospital. Please review the bill and contact us if you have questions.
- Prompt Pay Discount: Uninsured patients who pay their bills within 30 days receive an additional 10 percent discount.
- Payment Plans: Patients may choose to make payment arrangements for their hospital bill. For information call the Hotline, 650-696-5466.
- Third-Party Lien: People involved in an accident may be eligible for payment of their hospital services from a third party.
Charity Care: Uninsured patients who meet income and family size eligibility requirements can apply for partial or full charity care. All potential payment sources must be exhausted before a patient is eligible for charity. See the Charity Care Income Eligibility Chart for more information or call the hotline at 650 696-5466.
Catastrophic Coverage: Catastrophic medical coverage is available for people who do not have health insurance when their eligible medical bills exceed 30 percent of annual income. Assistance is provided for the amount over 30 percent.
Q. How do I know if I qualify for financial assistance for my hospital bills?
Refer to the chart at left for general information. Then request an application from the registration desk, or call the Hotline at 650 696-5466 to request one by mail. Follow instructions on the form, including providing income documentation such as your most recent tax return, two months of pay stubs or employer salary history. Let us know if you need help filling out the form. Business Services may need to contact you for additional information.
Q. How will I be notified?
Once the eligibility process is complete, you will receive notification by mail informing you whether you are eligible for full or partial financial ssistance. You may receive a request for more information.
Q: Can I apply for charity care to cover my insurance plan copay or deductible?
No. Financial assistance is designed for people who have no health insurance.
Charity Care Income Eligibility Guidelines
| 2009 Poverty Guidelines | ||||
| Family Size Period | Federal Poverty Guidelines | If income is below 351% (shown below)of FPG, eligible for Full Write-off | If income is above 351% but below 500% (shown below), eligible for Partial Write-off | |
| 1 | Annual | $10,830.00 | $37,905.00 | $54,150.00 |
| Monthly | $903.00 | $3,160 | $4,515.00 | |
| 2 | Annual | $14,570.00 | $50,995.00 | $72,850.00 |
| Monthly | $1,214.00 | $4,249.00 | $6,070.00 | |
| 3 | Annual | $18,310.00 | $64,085.00 | $91,550.00 |
| Monthly | $1,526.00 | $5,341.00 | $7,630.00 | |
| 4 | Annual | $22,050.00 | $77,175.00 | $110,250.00 |
| Monthly | $1,838.00 | $6,433.00 | $9,190.00 | |
| 5 | Annual | $25,790.00 | $90,265.00 | $128,950.00 |
| Monthly | $2,149.00 | $7,521.00 | $10,745.00 | |
| 6 | Annual | $29,530.00 | $103,355.00 | $147,650.00 |
| Monthly | $2,461.00 | $8,613.50 | $12,305.00 | |
| 7 | Annual | $33,270.00 | $116,445.00 | $166,350.00 |
| Monthly | $2,773.00 | $9,705.00 | $13,865.00 | |
| 8 | Annual | $37,010.00 | $129,535.00 | $185,050.00 |
| Monthly | $3,084.00 | $10,794.00 | $15,420.00 | Each Addtl Family Member | Annual | $3,740.00 | $13,090.00 | $18,700.00 | Each Addtl Family Member | Monthly | $312.00 | $1,092.00 | $1,560.00 |
- Medi-Cal
- County Medical Services Program (CMS)
- Victims of Crime (VOC)
- Breast, Cervical Cancer Treatment Program (BCCT)
- Genetically Handicapped Peoples Program (GHPP)
- Improving access, counseling and treatment for Californians with prostate cancer (Impact)
- Permanent Residence Under the Color of Law (PRUCOL)
- Healthy Families - California’s low-cost, medical, dental and vision care insurance program