Hawaii Pacific Health
Patient Financial Assistance Program · About this organization
What you get
Up to 100% off emergency and medically necessary hospital and employed-physician bills, depending on income and the review of your expenses.
How to start
Fill in the financial-assistance application and gather the income and expense documents it requests.
Good to know
- The linked policy carries an April 2021 effective date although it remains linked from the current 2026 program page.
- A family may apply before an appointment, when receiving care, after a bill arrives, or after the account enters collections.
The details, as published
Hawaii Pacific Health discounts eligible emergency and medically necessary HPH hospital and employed-physician bills for insured, underinsured, or uninsured patients of any age. Hawaii residents may apply broadly; nonresidents generally qualify only for emergency care unless an exception applies. Assistance is 100% at or below 200% FPG, an 85% discount above 200% through 400%, and may include medical-indigence review above 400%. Complete applications are usually processed within 30 calendar days and approvals generally last six months.
What help you may get
Household Bills And Cash Assistance
Patient Financial Assistance Program — household bills and cash assistance
Hawaii Pacific Health discounts eligible emergency and medically necessary HPH hospital and employed-physician bills for insured, underinsured, or uninsured patients of any age. Hawaii residents may apply broadly; nonresidents generally qualify only for emergency care unless an exception applies. Assistance is 100% at or below 200% FPG, an 85% discount above 200% through 400%, and may include medical-indigence review above 400%. Complete applications are usually processed within 30 calendar days and approvals generally last six months.
Amount not published
Can cover
- Eligible emergency or medically necessary charges billed by employed Hawaii Pacific Health physicians
- Eligible emergency or medically necessary hospital charges billed by Hawaii Pacific Health
- The patient-responsibility portion of medically necessary care after insurance, when all rules are met
Does not cover
- Care that is not emergency or medically necessary under the policy
- Retail prescription charges
- Services billed by non-Hawaii Pacific Health providers
- A medically indigent applicant above 400% FPG may receive an 85% discount when the balance meets the 15% income-and-liquid-assets test.
- The program publishes percentage discounts rather than dollar awards: 100% at or below 200% FPG and 85% above 200% through 400% FPG.
- Financial assistance is generally approved for six months, and patients generally reapply every six months.
Medical And Insurance Costs
Patient Financial Assistance Program — medical and insurance costs
Hawaii Pacific Health discounts eligible emergency and medically necessary HPH hospital and employed-physician bills for insured, underinsured, or uninsured patients of any age. Hawaii residents may apply broadly; nonresidents generally qualify only for emergency care unless an exception applies. Assistance is 100% at or below 200% FPG, an 85% discount above 200% through 400%, and may include medical-indigence review above 400%. Complete applications are usually processed within 30 calendar days and approvals generally last six months.
Amount not published
Can cover
- Eligible emergency or medically necessary charges billed by employed Hawaii Pacific Health physicians
- Eligible emergency or medically necessary hospital charges billed by Hawaii Pacific Health
- The patient-responsibility portion of medically necessary care after insurance, when all rules are met
Does not cover
- Care that is not emergency or medically necessary under the policy
- Retail prescription charges
- Services billed by non-Hawaii Pacific Health providers
- A medically indigent applicant above 400% FPG may receive an 85% discount when the balance meets the 15% income-and-liquid-assets test.
- The program publishes percentage discounts rather than dollar awards: 100% at or below 200% FPG and 85% above 200% through 400% FPG.
- Financial assistance is generally approved for six months, and patients generally reapply every six months.
Check the main eligibility rules
Diagnosis
B-ALL is in scope. The program covers medically necessary care regardless of age at Kapiolani, whose official pediatric cancer program treats children and adolescents with leukemia; B-ALL care is within that scope.
Age
Age 0 to no published upper limit, measured at treatment period.
- The policy states that services are provided regardless of age and publishes no upper patient-age limit.
Treatment status
No specific treatment status is published.
- Provider confirmation is not published as mandatory.
- Non-Hawaii Pacific Health providers who practice at an HPH location are excluded from this policy.
- The charge must be billed directly by a Hawaii Pacific Health facility or an employed Hawaii Pacific Health physician.
- Applicants may be screened for Medicaid eligibility and may need to provide a Medicaid denial letter when applicable.
- Insured, underinsured, and uninsured patients may apply.
Financial need is required.
- Above 200% through 400% of the federal poverty guidelines, the published discount is 85%.
- At or below 200% of the federal poverty guidelines, the published discount is 100%.
- Gross family income compared with current federal poverty guidelines for Hawaii.
- Income above 400% may still qualify under the medically indigent test when the balance is at least 15% of combined annual family income and liquid assets.
- Applicants are expected to use other assistance for which they are eligible.
- Applicants whose circumstances fall outside the standard discount guidelines may receive an individualized review.
Where you live and where your child is treated
Where your family lives
Residence coverage is not published clearly; confirm with the program.
- A Hawaii resident must be in the state for a purpose other than temporary or transitory for at least 30 days.
- Hawaii residents may apply for non-emergency medically necessary services; nonresidents normally may apply for emergency care.
Where your child is treated
Treatment must be through: Care must be emergency or medically necessary care billed by a Hawaii Pacific Health facility or employed physician, including Kapiolani Medical Center for Women & Children and Kapiolani Medical Specialists..
- Care must be emergency or medically necessary care billed by a Hawaii Pacific Health facility or employed physician, including Kapiolani Medical Center for Women & Children and Kapiolani Medical Specialists.
Where the service, camp, stay, or experience happens
- Hawaii — Hawaii — Hawaii
How to get started
Does a social worker or care team need to start it? No. A required care-team start is not published; the family can use the available route below.
Who can start: Caregiver, Parent Or Guardian, Patient
- Attach copies of the required financial records and a Medicaid denial letter if applicable.
- Complete the household, income, insurance, asset, and expense sections.
- Download the application or request a free copy from Hawaii Pacific Health.
- Respond to requests for missing information; HPH mails the approval, partial-approval, or denial decision.
- Submit the packet by email, mail, fax, or in person to a hospital financial counselor.
Ways to apply or ask
- Web Form · Open form or page
- Downloadable Form · Open form or page
- Phone · 866-266-3935 — Neighbor-island applicants may call Customer Service; financial counselors are also available at each HPH hospital.
Documents to prepare
- Completed Patient Financial Assistance application
- Letter explaining monthly expenses paid under another person's name, if applicable
- Liquid-asset information when requested
- Medicaid denial letter if applicable
- Most recent federal tax return or other requested income records
- Wage or income statements for the past 90 days
- An approved discount is applied to eligible Hawaii Pacific Health bills.
- The family remains responsible for any balance after a partial discount.
Availability and timing
| Program | Active |
|---|---|
| Applications | Open |
| Funding or space | Available |
| Application window | Rolling |
| Last checked | Aug 24, 2026 |
- The current official page provides active applications, translated materials, counselor contacts, and rolling application instructions.
- A family may apply before an appointment, when receiving care, after a bill arrives, or after the account enters collections.
- Applications are usually processed within 30 calendar days after all required documentation is received.
- Complete applications are usually processed within 30 calendar days.
Limitations and things to confirm
- A clinician who practices at an HPH hospital may still be excluded if not employed or otherwise covered by the policy.
- Approval generally covers six months.
- Covers HPH hospital and employed-physician bills; non-HPH professional bills and retail drugs or supplies are excluded.
- Do not use the policy appendix’s 2024 example dollar table as current FPG thresholds.
- Nonresidents ordinarily qualify only for emergency care unless HPH approves an exception.
- Only bills from Hawaii Pacific Health facilities and employed physicians are covered.
- The linked policy carries an April 2021 effective date although it remains linked from the current 2026 program page.
- Confirm current FPG dollar table, covered providers, nonresident exceptions, documents, and renewal.
Official sources
Program details were last verified Aug 24, 2026. Availability can change, so check the official program before applying.
- Financial Assistance Program — Hawaii Pacific Health · checked Aug 23, 2026
- Hawaii Pacific Health Patient Financial Assistance Application · checked Aug 23, 2026
- Patient Financial Assistance (Charity) Program · checked Aug 23, 2026
- Kapiolani Cancer Center — Pediatric and Women's Cancer Services · checked Aug 23, 2026
- Patient Financial Assistance Program · checked Aug 24, 2026
- Patient Financial Assistance Program · checked Aug 24, 2026
- Patient Financial Assistance Program · checked Aug 24, 2026