Patient Financial Assistance Program

Medical Billing Assistance & Financial Help

UCLA Health strives to provide quality patient care and meet high standards for the communities we serve. UCLA Health is committed to helping eligible patients who cannot pay for all or part of their care. UCLA Health’s commitment to our mission and vision includes providing financial assistance — up to a 100% discount — to eligible patients who are low income, uninsured or under-insured. Further information on UCLA Health’s Financial Assistance Program is provided below.

Eligible Services 

The Financial Assistance Program applies to emergency or other medically necessary healthcare services provided and billed by UCLA Health.

Hospital Services
Physician Services

Who Is Eligible?

Eligibility is determined based on review of a completed Financial Assistance Application and supporting documents, including proof of income, assets and liabilities. Generally, patients with family income at or below 400% of the Federal Poverty Level will be eligible for a discount of 100%. Patients with family income between 401% and 450% of the Federal Poverty Level may be eligible for a partial discount based on income level.

If you receive financial assistance under our policy, you will not be charged more for emergency or other medically necessary care than the amount generally billed to patients having Medicare fee-for-service coverage. In some instances, patients may be presumptively determined eligible for financial assistance.

To view U.S. federal poverty guidelines used to determine financial eligibility, visit aspe.hhs.gov/poverty-guidelines.

Financial Assistance Policy and Application

You can access our Financial Assistance Policy and application in multiple languages in the Helpful Links box below. You can also request the policy and application:

  • In our emergency departments, Patient Access Services Department (see address below), any UCLA Health location where patient registration occurs and in our Patient Business Services Office (see address below).
  • By mail, by contacting our Patient Business Services Office at 310-825-8021 (Monday through Friday, 8:30 am to 4 pm).

Languages/Translations

The Financial Assistance Policy, Financial Assistance Application and Plain Language Summary are available in English, Spanish, Farsi, Arabic and Chinese in the Documents section below on this page, or separately in paper upon request.

If you would like an interpreter to help you with a different language, please contact our Interpreter Services Program at 310-267-8001. The UCLA Health Interpreter/Translation Services Program provides services to all UCLA Health patients and their relatives at no cost. For more information regarding UCLA Health’s Interpreter/Translation Services Program, visit uclahealth.org/interpreters.

How to Apply

The Financial Assistance Application is found below on this page, and may be hand-delivered or mailed, with all supporting documents, to:

Hand-delivery:

Monday through Friday, 8:30 am to 4 pm

Patient Access Services Department
757 Westwood Plaza 
Los Angeles, CA 90095

Patient Business Services Department
10920 Wilshire Blvd., Suite 1600 
Los Angeles, CA 90024

Mail to:

Patient Business Services Department
10920 Wilshire Blvd., Suite 1600 
Los Angeles, CA 90024

Financial Assistance Program Documents

Financial Assistance Application

Hospital Bill Complaint Program

The Hospital Bill Complaint Program is a state program that reviews hospital decisions about whether you qualify for help paying your hospital bill. If you believe you were wrongly denied financial assistance, you may file a complaint with the Hospital Bill Complaint Program at HospitalBillComplaintProgram.hcai.ca.gov.

Questions?

  • Call the Patient Business Services Office: 310-825-8021 (Monday through Friday, 8:30 am to 4 pm)
  • Visit 10920 Wilshire Blvd., Suite 1600, Los Angeles, CA 90024