Medical Financial Assistance Program for the Northwest

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• Who is eligible? »
• What does the program cover? »
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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.

What's new?

As of October 1, 2022, patients with Medicare Part D who are approved for a partial MFA award will be expected to pay the remaining balance at the point of sale or when ordering by mail. 

Award amounts are based on your household income as a percentage of the 2023 federal poverty guidelines:

• 100% of your share of eligible costs for households with incomes at or below 200% of the federal poverty guidelines
• 75% of your share of eligible costs for households with incomes between 201% and 300% of the federal poverty guidelines
• 50% of your share of eligible costs for households with incomes between 301% and 350% of the federal poverty guidelines
• 25% of your share of eligible costs for households with incomes between 351% and 400% of the federal poverty guidelines

Visit aspe.hhs.gov/poverty to find the guidelines for larger households.

Disclaimer

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. An MFA award is not a covered benefit and does not change the services covered or cost-sharing owed under your plan.

Who is eligible for Financial Assistance and what are the requirements?

The Medical Financial Assistance program helps low-income, uninsured, or underinsured patients who need help paying for all or part of their medical care received from Kaiser Permanente. Patients are eligible for financial assistance when their family income is at or below 400% of the Federal Poverty Guidelines. Patients should consult with a counselor to determine eligibility and for assistance applying. Patients who have experienced unusually high medical expenses may be eligible for the program, regardless of household income. Refer to the MFA policy for a complete description of the program eligibility requirements.

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.

Which providers are and are not covered under the program?

The list of providers in Kaiser Foundation Hospitals that are and are not covered under the MFA policy can be found in our Kaiser Permanente provider list for the Northwest.

How can I get program information?

Copies of the MFA policy, application forms, instructions, and plain language summaries (such as 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 1-800-813-2000 to request electronic copies. Please be prepared to provide an email address that the information can be sent to when calling.

Request information by telephone: Counselors are available by telephone to determine MFA eligibility, and assist with applying for MFA. Counselors can be reached by calling Membership Services at 1-503-813-2000 or 1-800-813-2000 (TTY 711). Monday through Friday, 8 a.m. to 6 p.m. Pacific time.

Request program information by U.S. mail: A patient can request program information by mail. Information requests can be mailed to:

Kaiser Permanente
Attention: Financial Counselors
500 NE Multnomah Street
Portland, OR 97232

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. 

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.