Medical Financial Assistance Program

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.

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

The Medical Financial Assistance (MFA) 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 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 (i.e. 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, 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.

Medical Financial Assistance Policy (English) Spanish, Vietnamese
Program Summary (English) Spanish, Vietnamese
Program Application (English) Spanish, Vietnamese

Request program information electronically: Electronic copies of program information are available by email upon request. Call 844-412-0919 to request electronic copies. Please be prepared to provide an email address that the information can be sent to when calling.

Obtain program information in person: Counselors are available at Kaiser Permanente facilities to provide program information.  Counselors are available at the Administration Department in each Kaiser Permanente medical office building.

Request program information by telephone: Counselors are available by telephone to provide information, determine MFA eligibility, and assist a patient to apply for MFA. Counselors can be reached at: 844-412-0919 Monday through Friday, 9:30 a.m. to 3:30 p.m.

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

Kaiser Permanente
Attention: Medical Financial Assistance Program
2101 East Jefferson Street
Rockville, MD 20852-9468

How do I apply?

A patient can apply for the MFA program, during or following the care received from Kaiser Permanente, in several ways:

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Apply online

  • Before starting the online application process, be prepared to provide all the information listed on the MFA application.
  • To begin your application, please fill out and submit the form below. Once submitted, you will receive instructions via email on how to complete your application. 

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Meet with a financial counselor

These services are unavailable at this time.

  • Schedule an appointment with a financial counselor at one of our designated facilities, Monday through Friday, 9:30 a.m. to 3:30 p.m. Eastern time.
  • Be prepared to provide all the information listed on the MFA application.
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Call us

  • Call us at 844-412-0919 (TTY 711), Monday through Friday, 9:30 a.m. to 3:30 p.m. Eastern time.
  • Be prepared to provide the information listed on the MFA application
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Mail it

  • Complete the MFA application.
  • Mail your completed application to:

    Kaiser Permanente MFA Program
    2101 East Jefferson Street
    Rockville, MD 20852 
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Fax it

Complete the MFA application.

Fax your completed application to 855-414-1713.

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Drop it off

  • Complete the MFA application.
  • Drop off your completed application at the Patient Business Office at any Kaiser Permanente facility.

Kaiser Permanente will review submitted applications when they are complete and will determine whether you are eligible according to the Kaiser Permanente Medical Financial Assistance Policy. Incomplete applications may result in a delay in processing or denial of your MFA application, but Kaiser Permanente will notify applicants and provide an opportunity to send in the missing documentation or information, by the required deadline.

Amounts Generally Billed (AGB)

Amounts Generally Billed apply to eligible hospital services rendered at a Kaiser Foundation Hospital only and do not apply to services provided by the Mid-Atlantic States Region.

Is there language assistance?

Interpreters are available to you at no cost. The medical financial assistance application, policy, and the policy summary may be available in your language. For more information, call 844-412-0919.

Other beneficial programs and extra resources:

If you don’t have health care coverage and would like more information, call us at 1-800-479-5764 (TTY 711) Monday through Friday between 9 a.m. and 5 p.m. to learn more about your coverage options.

We’re here to support you however we can. If you need help with essentials like housing, childcare, or food, Thrive Local Connections can help connect you to resources in your community. Call 1-800-443-6328 (TTY 711), Monday through Friday between 8 a.m. and 5 p.m.

Need help?

For help or questions about the Medical Financial Assistance application process or other questions, please call 844-412-0919, or speak to a MFA Specialist within the MFA Department or the Administration office at your local Kaiser Permanente Medical Center Building.