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Pacifica Hospital Of The Valley — Financial Assistance & Charity Care
Sun Valley, Los Angeles County, CA
Under California law (the Hospital Fair Pricing Act), Pacifica Hospital Of The Valley must offer free or discounted care to patients who can't afford their bills. Here's who qualifies and how to apply — you can apply even if your bill already went to collections.
Do you qualify for FREE care?
Pacifica Hospital Of The Valley provides free (charity) care to patients at or below 400% of the Federal Poverty Level. If your yearly household income is at or below the amount for your household size, you likely qualify for 100% free care:
| Household size | Yearly income at or below | You likely qualify for |
|---|---|---|
| 1 person | $63,840/yr | 100% free care |
| 2 people | $86,560/yr | 100% free care |
| 3 people | $109,280/yr | 100% free care |
| 4 people | $132,000/yr | 100% free care |
| 5 people | $154,720/yr | 100% free care |
| 6 people | $177,440/yr | 100% free care |
| 7 people | $200,160/yr | 100% free care |
| 8 people | $222,880/yr | 100% free care |
Discounted care
Patients up to 500% of the Federal Poverty Level qualify for discounted care — you'd owe no more than the amount generally billed to insured patients:
| Household size | Yearly income at or below | You likely qualify for |
|---|---|---|
| 1 person | $79,800/yr | discounted care |
| 2 people | $108,200/yr | discounted care |
| 3 people | $136,600/yr | discounted care |
| 4 people | $165,000/yr | discounted care |
| 5 people | $193,400/yr | discounted care |
| 6 people | $221,800/yr | discounted care |
| 7 people | $250,200/yr | discounted care |
| 8 people | $278,600/yr | discounted care |
What you'll need to apply
- Recent pay stubs (preferably three consecutive months prior to month of application) for income
- Income tax returns
- W-2 form
- Self-employed Schedule C forms
- Medical assistance eligibility/denial notice, if applicable
- Social Security check stubs
How to apply
Based on this hospital's policy effective 01/01/2024.
Not sure if you qualify?
Answer 3 quick questions and get a personalized plan plus a ready-to-send request letter — free, in your language.
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