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.
or
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 and you must have a family income of no more than 350% of the Federal Poverty Guidelines.
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.
Appeals
If you believe your application was not properly considered, you may send us a written request for reconsideration. Please send it to:
Director of Single Business Office
John Muir Health
5003 Commercial Circle
Concord, CA 94520
More Information
If you have questions, please call Patient Financial Services at (925) 947-3336, Monday through Friday, between 8:00 AM and 5:00 PM.