Patient Financial Assistance

Payment and Insurance

John Muir Health funds a patient assistance program that may cover all or part of your hospital bills. Your eligibility is based partly on your household income. To qualify, you must meet one of the following sets of criteria:

A. You must have no insurance or other third party that will pay all or part of your hospital bill. You also must have a family income of no more than 400% of the Federal Poverty Guidelines.

B. You have some form of third-party insurance coverage, but you do not receive a discounted rate from John Muir Health because of that coverage. Also, your annual out-of-pocket costs for medical expenses must exceed 10% of your family income in the past 12 months.

How to Apply

To qualify, you will need to complete the patient assistance application form and submit the required documents, including:

Recent pay stubs (or certification that you are currently unemployed)
Last federal income tax return, including all schedules
Last federal income tax return for the individual who claims you as a dependent, if applicable

Other documents may be requested, depending on your circumstances. To get an application, you can check the box on your bill stub and return it to the address on your bill, or download the application.