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.

What's new?

Starting in July 2021, new Medical Financial Assistance award amounts may be lower than those you’ve received in the past. Beginning in July, patients with household incomes between 201% to 300% of 2021 federal poverty levels who reapply may receive a 75% award instead of the current 100% award on eligible medical and outpatient pharmacy costs. Households with lower incomes may qualify for an award covering 100% of their share of eligible medical and outpatient pharmacy costs. See the chart below to find out where your income falls in the new guidelines.

Please note: Beginning July 2021, all 25%, 50%, and 75% current MFA awards will now be applied to outpatient pharmacy. If you have a 25%, 50%, or 75% MFA award, you are expected to pay the remaining outpatient pharmacy balance at point of sale or when ordering by mail. All patients with Medicare who are approved for MFA will continue to receive a temporary 100% award for pharmacy until further notice.

Award amounts will be based on your household income as a percentage of the 2021 federal poverty levels:

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

Household/family size Income at or below 200% Income between 201% and 300% Income between 301% and 350% Income between 351% and 400%
1 Up to $25,760 $25,761 to $38,640 $38,641 to $45,080 $45,081 to $51,520
2 Up to $34,840 $34,841 to $52,260 $52,261 to $60,970 $60,971 to $69,680
3 Up to $43,920 $43,921 to $65,880 $65,881 to $76,860 $76,861 to $87,840
4 Up to $53,000 $53,001 to $79,500 $79,501 to $92,750 $92,751 to $106,000
5 Up to $62,080 $62,081 to $93,120 $93,121 to $108,640 $108,641 to $124,160
6 Up to $71,160 $71,161 to $106,740 $106,741 to $124,530 $124,531 to $142,320

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 (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 of 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: Electronic copies of program information are available:

Medical Financial Assistance Policy (English) Arabic, Armenian, Chinese, Farsi, French, Japanese, Khmer, Korean, Laotian, Russian, Spanish, Tagalog, Vietnamese
Program Summary (English) Arabic, Armenian, Chinese, Farsi, French, Japanese, Khmer, Korean, Laotian, Russian, Spanish, Tagalog, Vietnamese
Program Application (English) Arabic, Armenian, Chinese, Farsi, French, Japanese, Khmer, Korean, Laotian, Russian, Spanish, Tagalog, Vietnamese

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.

Obtain program information in person: Program information is available at Admitting and Emergency Room Departments in Kaiser Foundation Hospitals. 

Counselors are available at the following facilities:

  • Sunnyside Medical Center
  • Westside Medical Center

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 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?

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

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. 

Icon representing an appointment - a calendar with a check mark on it.

Meet with a financial counselor

  • Schedule an appointment with a financial counselor at one of the Kaiser Permanente facilities listed below, Monday through Friday, 8:30 a.m. to 5 p.m. Pacific time.
    • Sunnyside Medical Center
    • Westside Medical Center
  • Be prepared to provide all the information listed on the MFA application.
Icon of a telephone receiver.

Call us

  • Counselors are available by telephone to determine MFA eligibility, and assist a patient to apply for MFA.
  • Call us at 1-800-813-2000 (TTY 711), Monday through Friday, 8 a.m. to 6 p.m. Pacific time.
  • Be prepared to provide all the information listed on the MFA application.
Icon of an envelope.

Mail it

  • Complete the MFA application.
  • Mail your completed application to:
  • Kaiser Permanente
    Attention Financial Counselors
    500 NE Multnomah St.
    Portland, OR 97232

Icon of a fax machine with a sheet of paper in it.

Fax it

  • Complete the MFA application.
  • Fax your completed application to 877-829-3547.
Icon of a sheet of paper and a pen, with writing on it.

Drop it off

  • Complete the MFA application.
  • Drop off your completed application with the Registration (check-in) staff at any Kaiser Permanente facility. For questions about MFA please call Member Services 503-813-2000, Monday through Friday, 8 a.m. to 6 p.m. Pacific time.

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

Amounts Generally Billed is based on the lowest average of the amounts that were paid to a Kaiser facility by Medicare fee-for-service and Medicaid fee-for-service (and co-pays and deductibles) for emergency or medically necessary services, based on actual claim data from October 1, 2019 to September 30, 2020, which is consistent with the look-back method. Total expected payment from allowed claims was divided by total billed charges for such claims, and that number was subtracted from 1 to calculate the AGB percentage. The 2021 AGB reduction to gross charges is 63% for hospital charges.

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 1-800-324-8010, or TTY 711.

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, or 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, or 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 1-800-813-2000, or speak to a financial counselor near the Patient Access Business Services Department at any Kaiser Permanente hospital.