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.
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 400% 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.
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.
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 Southern California.
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)||Arabic, Armenian, Chinese, Farsi, French, German, Greek, Gujarati, Hebrew, Hindi, Hmong, Hungarian, Italian, Japanese, Korean, Laotian, Mon-Khmer, Polish, Portuguese, Russian, Serbo-Croatian, Spanish, Tagalog, Thai, Urdu, Vietnamese|
|Program Summary (English)||Arabic, Armenian, Chinese, Farsi, French, German, Greek, Gujarati, Hebrew, Hindi, Hmong, Hungarian, Italian, Japanese, Korean, Laotian, Mon-Khmer, Polish, Portuguese, Russian, Serbo-Croatian, Spanish, Tagalog, Thai, Urdu, Vietnamese|
|Program Application (English)||Arabic, Armenian, Chinese, Farsi, French, German, Greek, Gujarati, Hebrew, Hindi, Hmong, Hungarian, Italian, Japanese, Korean, Laotian, Mon-Khmer, Polish, Portuguese, Russian, Serbo-Croatian, Spanish, Tagalog, Thai, Urdu, Vietnamese|
Request program information electronically: Electronic copies of program information are available by email upon request. Call 1-800-390-3507 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, Emergency Room, and Patient Financial Advisors Departments at any Kaiser Foundation Hospitals in Southern California.
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 1-800-390-3507 Monday through Friday, 8 a.m. to 5 p.m.
Request program information by U.S. postal mail: A patient can request program information by mail. Information requests can be mailed to:
Attention: Medical Financial Assistance
P.O. Box 7086
Pasadena, CA 91109-7086
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|
|Alimony/child support||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.
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.