Medical Financial Assistance Program

• What’s new? »
• Who is eligible? »
  
• What does the program cover? »
• How do I apply? »
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Having trouble paying for your Kaiser Permanente medical and pharmacy expenses?

Kaiser Foundation Hospitals and Kaiser Foundation Health Plans, 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 low-income, uninsured, and underinsured patients when the ability to pay for services is a barrier to accessing emergency and medically necessary care. Patients must meet the eligibility requirements below to qualify.

What’s new?

Starting in October 2021, new Medical Financial Assistance award amounts may be lower than those you’ve received in the past. Patients with household incomes between 201% to 300% of 2021 federal poverty levels who reapply may receive a 50% award instead of the current 100% award on eligible medical and outpatient pharmacy costs. Households with lower incomes may qualify to continue receiving 100% awards. See the chart below to find out where your income falls in the new guidelines.

Please note: There’s no change to financial help you may be getting now. Changes will go into effect for applications received starting October 2021. If you receive a 50% award, you are expected to pay the remaining outpatient pharmacy balance at point of sale or when ordering by mail. All Medicare patients approved for MFA will continue to receive a temporary 100% award for pharmacy until further notice.

Award amounts will be based on your gross household income (before taxes) as a percentage of the 2021 federal poverty level:

• 100% of your share of eligible costs for households with incomes at or below 200% of the federal poverty level
• 50% of your share of eligible costs for households with incomes between 201% and 300% of the federal poverty level

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

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 (MFA) program helps low-income, uninsured, and underinsured patients who need help paying for all or part of their medical care received from Kaiser Permanente and Kaiser Permanente network providers. Patients are eligible for financial assistance when their family income is at or below 300% of the Federal Poverty Guidelines (FPG). 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 (e.g., hospitals, medical centers, and medical offices), 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, instructions, and plain language summaries (e.g., 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. postal mail.

Download program information: Electronic copies of program information are available:

Request program information electronically: Electronic copies of program information are available by email upon request. Call 1-866-899-6018 to request electronic copies. When calling, please be prepared when to provide an email address to receive the requested information.

Obtain program information in person: Financial Counselors are available Monday thru Friday from 10 a.m. to 10 p.m. and Saturday through Sunday from 8 a.m. to 6 p.m. at the Patient Registration Department in each Kaiser Permanente medical office listed below to provide program information and to quickly determine MFA eligibility.

Aurora Centerpoint