Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
Search Saved

California program

Reduce hospital bills (California Hospital Fair Pricing Act)

Help reducing hospital bills under California law for eligible uninsured families and families with high medical costs.

What it is

Help reducing hospital bills under California law for eligible uninsured families and families with high medical costs.

Even with insurance, you may be left with hospital bills. The financial counselor can compare your income and medical costs with state protections and the hospital’s own policy. A hospital may offer more help than the state minimum.

Who can get it
  • The state income limit is 400% of poverty: $132,000 annually for four in 2026.
  • The state minimum generally protects uninsured patients and insured patients meeting its high-medical-cost definition at or below 400% of poverty. Your hospital may offer broader help. Ask the counselor to check its own policy, rather than assume every insured family must meet the same 10% test.
  • For the statutory discount, the hospital cannot require a monetary-asset test or an outside-coverage application. Extra charity help may have different rules, but cannot reduce your state minimum rights. There is a narrow rural-hospital exception.
What you get
  • Eligible charges capped at the higher Medicare or Medi-Cal rate.
  • Interest-free payment plans for remaining eligible balances.
  • No savings test, and no deadline in the law for asking.
What you get
  • Eligible discounted charges cannot exceed the higher Medicare or Medi-Cal rate.
  • Payment plans are interest-free. The fallback payment calculation uses 10% of income after essential living expenses.
  • For the protected patient group, state law bars beginning a civil action before 180 days after initial billing. Routine bills or collection contacts are not all barred.
If you decide to apply
  1. Ask the hospital financial counselor for its assistance form and help requesting a hold on the account.
  2. Have ready: household income proof, the itemized bill and your insurance explanation of benefits.

Hospital financial counseling; HCAI Hospital Bill Complaint Program · Official page ↗

What happens next
  • Your written award should name the accounts, billing groups, service dates, approval period and remaining balance. It does not automatically cancel separate doctors’ bills.
  • The counselor confirms which accounts are covered and whether the requested hold is in place.
  • A refusal can be reviewed through HCAI’s Hospital Bill Complaint Program.
Good to know

A hospital may offer more help than state law requires. Separately billing doctors may use different policies.

What else to know
  • Hospital policies can exceed the state minimum. Kaiser’s policy includes help at any income when eligible bills reach 10% of income.
  • Each bill names who sent it. Children's Hospital Los Angeles assistance does not automatically include CHLA Medical Group or USC doctors' bills; the counselor has the current list of included and excluded billers.
  • A hospital cannot sue you in the first 180 days after the first bill, and a complete assistance application at a nonprofit hospital pauses serious collection steps while it decides. Ordinary statements can still arrive; a written note of which accounts are on hold settles it.
  • An insurance appeal may create a separate extension under state law. Billing or a qualified legal adviser must confirm the applicable protection and dates for your account. Court papers have their own deadlines even when a billing hold is expected.
  • California residence does not make California hospital law govern an out-of-state or federal military hospital. The treating facility’s counselor can check its own policy and billing rules.

Federal background: Hospital financial assistance can reduce eligible bills, including balances left after insurance. California hospital discount rights.

Official sources
Ask your social worker

“Could the hospital reduce any bills left to us, and would its policy cover separate doctors’ bills? What would we still owe? Is applying worthwhile, and could you help with the application and a written account hold if appropriate?”

Why I’m asking: I want to understand which hospital bills can be reduced.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Ask for the financial-assistance application and a hold on the account, hand in income proof, and do not sign a payment plan until the decision.

Your social worker

The financial counselor runs the income and 10%-of-income test and applies the hospital's own policy first. The social worker can get the counselor to your room.

The care team

Records and letters when the application asks for them.

Who decides
The hospital's financial-assistance office. HCAI on complaint
Ask the billing office
“Please send the assistance application and hold the account. Which doctors bill separately?”

How to apply

First step: Ask the hospital financial counselor for the financial-assistance application and a hold on the account while it is reviewed. If refused, file at hospitalbillcomplaintprogram.hcai.ca.gov.

  1. Ask the financial counselor for the application and a hold on the account.
  2. Ask for the list of separately billing groups.
  3. File at HCAI if refused.

Official application / program page ↗

Where it starts: Hospital application. HCAI complaint if refused

What to gather

  • Income proof for the household
  • The plan's explanation of benefits showing your out-of-pocket
  • The itemized bill

How long: No statutory deadline for you. Ask the hospital for its decision date and keep the hold in place.

What a yes looks like

A written award: charges reduced to the Medicare or Medi-Cal rate or written off, and an interest-free plan for any remainder.

What a no looks like, and the next move

Ask for the refusal and its reason in writing. If the hospital overlooked the 10% test or the 400% line, file a complaint and ask billing to keep the account on hold.

Watch out

  • The hospital's own policy may be more generous than state law. Apply there first. Kaiser can provide full assistance at any income when bills reach 10% of income.
  • Doctors who bill separately are not always covered by the hospital policy. Ask for the list.
  • Complaints go to Department of Health Care Access and Information (HCAI)'s Hospital Bill Complaint Program, not the plan.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 8, 2026.

What it is worth

Eligible hospital charges are capped, with interest-free qualifying payment plans and no monetary-asset test or statutory application cutoff. The 180-day protection concerns starting a civil action, not every collection activity.

  • $132,000/year — Family of 4 annual income limit (400% FPL, 2026)
  • $180 — No civil action before

Legal protection: Discounted charges capped at the greater of the Medicare or Medi-Cal rate · Interest-free payment plans. A 10%-of-income-after-essentials fallback · No civil action before 180 days after initial billing · No monetary-savings limit. No application cutoff · Complaint option through HCAI's Hospital Bill Complaint Program

What it costs the family: Free application.

The eligibility facts, as published

Income percent fpl max
400
Uninsured or high medical cost
out-of-pocket medical costs above 10% of family income
Asset test
none

Decisions this site cannot make: Hospital calculation

Expect friction on: Separately billing physicians · Documentation

The trap: Accepting a payment plan before applying. Apply first. The hospital's own policy is often more generous than the state minimum protection.

Where I read this

← Back to your options