Having trouble paying for your Kaiser Permanente medical and pharmacy expenses?
Kaiser Foundation Health Plan and Kaiser Foundation Hospitals, collectively referred to as Kaiser Permanente, are committed to providing programs that facilitate access to care for vulnerable populations. This commitment includes providing financial assistance to qualified patients who are uninsured or underinsured and have low incomes, when the ability to pay for services is a barrier to accessing emergency and medically necessary care. Patients must meet the eligibility requirements explained below to qualify.
As of March 1, 2022, 50% awards apply to outpatient, specialty, and mail-order pharmacy. If you have a 50% MFA award, you are expected to pay the remaining pharmacy balance at the point of sale or when ordering by mail.
Beginning October 1, 2022, patients with Medicare Part D who are approved for a partial MFA award will be expected to pay the remaining pharmacy balance at point of sale or when ordering by mail.
*Family income based on the 2022 federal poverty levels:
- 100% of your share of eligible medical costs for households with incomes at or below 200% of the federal poverty level
- 50% of your share of eligible medical costs for households with incomes between 201% and 300% of the federal poverty level
If your household or family size is:
|2022 federal poverty guidelines
|100% award for gross annual income at or below 200% of FPG
||50% award for gross annual income between 201% and 300% of FPG
||$27,181 to $40,770
||$36,621 to $54,930
||$46,061 to $69,090
||$55,501 to $83,250
||$64,941 to $97,410
||$74,381 to $111,570
Past MFA award recipients aren’t guaranteed future awards. Kaiser Permanente reserves the right to change the terms and conditions of the MFA program at any time. The MFA award is not a covered benefit and will not impact your existing plan coverage.
What does the program cover?
The MFA program covers emergency and medically necessary health care services, pharmacy services and products, and medical supplies provided at Kaiser Permanente facilities (such as hospitals, medical centers, and medical office buildings), at Kaiser Permanente outpatient pharmacies, or by Kaiser Permanente providers. Services that are not considered emergent or medically necessary as determined by a Kaiser Permanente provider include, but are not limited to, cosmetic surgery or services, infertility treatments, retail medical supplies, surrogacy services, and services related to third-party liability, or workers’ compensation cases. Refer to the MFA Policy for a complete list of eligible and ineligible services.
How can I get program information?
Copies of the MFA policy, application forms, application forms, instructions, and plain-language summaries (including policy summaries or program brochures) are available to the general public, without charge, from Kaiser Permanente's website, by email, in person, by telephone, or by U.S. mail.
Download program information:
Request program information electronically: Electronic copies of program information are available by email upon request. Call 404-949-5112 to request electronic copies. Please be prepared to provide an email address that the information can be sent to when calling.
Request program information by telephone: 404-949-5112, or TTY: 800-255-0056. Monday through Friday, 8:30 a.m. to 4:30 p.m.
Obtain program information in person: Counselors are available at Kaiser Permanente facilities to provide program information and to quickly determine MFA eligibility. Counselors are available at the following medical office buildings to assist patients:
- Cascade Medical Center
- Crescent Medical Center
- Cumberland Medical Center
- Glenlake Medical Center
- Gwinnett Medical Center
- Panola Medical Center
- Southwood Medical Center
- Sugar Hill-Buford Medical Center
- Town Park Medical Center
Request program information by U.S. mail: A patient can request program information by mail. Information requests can be mailed to:
Attention: Patient Financial Services
Nine Piedmont Center
3495 Piedmont Road, Northeast
Atlanta, Georgia 30305-1736
How do I apply?
You can apply for medical financial assistance through Kaiser Permanente during or following a course of care or treatment received from Kaiser Permanente. To be eligible for the program, you must demonstrate an immediate need caused by a bill for an outstanding balance for Kaiser Permanente services, a scheduled appointment with Kaiser Permanente, or a pharmacy prescription ordered by a Kaiser Permanente provider for eligible services and meet income qualifications.
When you apply, you will be asked to list your household size and total gross household income, which will be validated by an external data source. Applying online is the quickest and easiest way to apply. If your income recently changed or you prefer to submit current financial documentation, you can fax or mail your MFA program application, along with your supporting financial documentation, as specified below.
Household income source
|Financial documentation to submit
|Employment income wages
||Current pay stub with pay period and year-to-date gross wages
|Business income/rental property
||Most recent tax return and all schedules
|Unemployment benefits/disability income
||Unemployment Benefit Payment Summary showing your gross weekly benefits
||Court Divorce Decree/amount awarded
|Pension or retirement/annuities
||Monthly gross benefit letter or most recent tax return and all schedules filed
|Social Security/Supplemental Security Income/veterans benefits
Social Security and/or monthly veterans benefit letter showing the gross benefit
Important: Any missing or unclear information may delay the application process or result in a denial.
What should I expect after I apply?
After we review your completed application, we’ll send you a decision within thirty (30) days of receipt. If it is not approved, we will provide a reason for the denial and instructions on how to appeal the decision if you disagree.