Help Paying Your Bill: Financial Assistance and Charity Care

UCI Health strives to provide quality patient care that meets high standards for the communities we serve.

This policy demonstrates UCI Health’s commitment to our mission — Discover, Teach, Heal — and our vision by helping to meet the needs of the low-income, uninsured patients and the underinsured patients in our community.

The Hospital Bill Complaint Program is a state program that reviews hospital decisions about whether you qualify for help paying your hospital bill. If you believe you were wrongly denied financial assistance, you may file a complaint with the Hospital Bill Complaint Program. Go to hospitalbillcomplaint.hcai.ca.gov for more information and to file a complaint.

Financial assistance at UCI Medical Center and related UCI Health locations

The Financial Assistance Program, also known as Charity Care, offers emergency and other medically necessary services at low or no cost to the patient.  

Determination of eligibility for the Financial Assistance Program is made based on review of the completed financial screening form and the receipt of the following documents:

• Proof of income

Generally, patients with family income at or below 200% of the federal poverty level will be eligible for a discount of 100%.

If you receive financial assistance under our policy, you will not be billed more for emergency or other medically necessary care than the amount we generally bill patients who have Medicare coverage.

Where to find our financial assistance policy

You may obtain a copy of our Financial Assistance Policy and application in several ways:

• Download a copy in English
• Pick up a physical copy from the Emergency Department, Patient Financial Services Department, or any location where patient registration occurs.
• Apply for Financial Assistance through MyChart

How to obtain information and assistance

For information regarding our Financial Assistance Program, please contact our Shared Business Office at 833-353-7700, Monday through Friday from 8:30 a.m. to 4 p.m.

What languages are available?

The Financial Assistance Policy, Financial Screening Form and Plain Language Summary are available in English, Spanish and Vietnamese.

Financial Screening Form:

• English
• Spanish
• Vietnamese

Practitioners who do not participate in financial assistance

Certain UCI Health physicians, such as those not contracted with the UCI Health Medical Group rendering healthcare services at UCI Health, do not participate with UCI Health’s Financial Assistance Program.

Where to send your application

Return your completed application to:

1500 S. Douglass Road, Suite 200
Anaheim, CA 92806

Financial assistance at UCI Health — Fountain Valley, UCI Health — Los Alamitos, UCI Health — Lakewood, UCI Health — Placentia Linda and related locations

Our hospital requests payment for services at the time of discharge from the Outpatient and Emergency Departments. A Patient Access staff member will notify you of your financial obligation, such as insurance co-payments or self-pay responsibility. This will be collected during the discharge process. There are organizations (such as the Health Consumer Alliance) that can help you understand the billing and payment process. You can find a list of shoppable services offered by our hospital on our price transparency page.

For patients who do not have insurance coverage, there are alternate funding and payment plan options offered by our hospital. Our Patient Access staff will work with you to identify the best payment option based on government or hospital rules and regulations. The following is an overview of the financial assistance programs provided by our hospital.

Policy: Financial Assistance for Uninsured Patients

Eligibility and Enrollment Services (EES)

The Eligibility and Enrollment Services (EES) Program is a hospital service provided to you at no cost. You may qualify for government programs, or for coverage through the California Health Exchange, which would pay for all or part of your hospital and medical expenses. Our Patient Advocates will provide applications and are available to assist you in the application process.

Charity Care Program — Financial Assistance 

A Financial Assistance Program is available to patients that do not have the means to pay for hospital expenses and do not qualify for any Medical Eligibility Programs. You may qualify if your household income is below 400% of the federal poverty limit and you are either uninsured or have medical expenses that exceed 10% of your annual household income. To be considered for the financial assistance, you will need to provide information on your household finances through a confidential Financial Application. Documentation will be requested to verify your circumstances in order to determine eligibility. Please contact EES at (844) 320-0965 Monday through Friday from 9 a.m. to 4:30 p.m. PT.

Uninsured Discount Program 

All uninsured patients are eligible for discounts. The discount is similar to rates paid by commercial insurance payors and is offered to you under an Uninsured Discount Program. A non-profit credit counseling service may be available in your area. Outside assistance programs

• Medicaid/Medi-Cal
• Supplemental Security Income
• Temporary Assistance for Needy Families
• County Indigent
• Social Security Disability
• Victims of a Violent Crime Fund
• Medical Low-Income Adults

In addition, you may qualify for the Healthy Families Program, California Children's Services or coverage through the California Health Exchange. In some cases, you may be eligible for coverage through Covered California or Medi-Cal for care that was provided prior to your application to these programs. Your EES representative can provide you with more information. Contact EES at 844-320-0965 Monday through Friday from 9 a.m. to 4:30 p.m. PT.