KAISER FOUNDATION HOSPITAL FONTANA/ONTARIO
FONTANA, CA · version 1 · published · JSON
eligibility.free_care_max_fpl200% of the federal poverty level"Federal Poverty Guidelines Percentages Financial Assistance Discount From To 0% -200% 100% Discount (Full)"
documented · checked 2026-10-13 · POLICY TITLE: Medical Financial Assistance
eligibility.discount_tiersAbove 200% up to 300% of FPL: 75% discountAbove 300% up to 350% of FPL: 50% discount
Above 350% up to 400% of FPL: 25% discount
"Federal Poverty Guidelines Percentages Financial Assistance Discount From To 0% -200% 100% Discount (Full) 201% -300% 75% Discount (Partial) 301% -350% 50% Discount (Partial) 351% -400% 25% Discount (Partial)"
documented · checked 2026-10-13 · POLICY TITLE: Medical Financial Assistance
eligibility.asset_testNo"Assets are not considered income."
documented · checked 2026-10-13 · POLICY TITLE: Medical Financial Assistance
eligibility.insured_patients_coveredYes"Eligible insured patients receive DFA on the patient cost for all eligible services."
documented · checked 2026-10-13 · POLICY TITLE: Medical Financial Assistance
programs.presumptiveMedicaid"• Enrolled in a or likely eligible for a government health coverage program like Medicaid, Medicare Low Income Subsidy Program (LIS), or subsidized coverage from the Health Benefit Exchange."
documented · checked 2026-10-13 · POLICY TITLE: Medical Financial Assistance
apply.documents_requiredProof of income"Proof of income Providing proof of income helps us determine if you qualify."
documented · checked 2026-10-13 · Medical Financial Assistance Policy Summary
apply.submit_methodsMail: Mail your completed application to: Kaiser Permanente MFA Program P.O. Box 7086 Pasadena, CA 91109-7086Fax: Fax your completed application to 1-866-519-1693
Portal: visit kp.org/helppaybills and sign up to receive a link to our secure online application
In person: Drop off your completed application at your local Kaiser Permanente Admitting Department.
"Ways to apply Apply online kp.org/helppaybills Fax it in Fax your completed application to 1-866-519-1693 Mail it in Mail your completed application to: Kaiser Permanente MFA Program P.O. Box 7086 Pasadena, CA 91109-7086 Drop it off Drop off your completed application at your local Kaiser Permanente Admitting Department."
documented · checked 2026-10-13 · Medical Financial Assistance Policy Summary
apply.decision_days30 days"If your application is complete, we will send you a letter with our decision within 30 business days."
documented · checked 2026-10-13 · Medical Financial Assistance Policy Summary
contacts.phone1-800-390-3507"You can also call 1-800-390-3507."
documented · checked 2026-10-13 · Medical Financial Assistance Policy Summary
contacts.hoursMonday through Friday, 8 a.m. to 5 p.m."Call us at 1-800-390-3507 (TTY 711), Monday through Friday, 8 a.m. to 5 p.m. Pacific time to find the nearest Kaiser Permanente hospital that provides in-person assistance with your application."
documented · checked 2026-10-13 · Medical Financial Assistance Policy Summary
contacts.languagesEnglishSpanish
Chinese
Tagalog
Vietnamese
Korean
Russian
Arabic
Armenian
Hindi
Hmong
Japanese
Khmer
Laotian
Mien
Navajo
Punjabi
Thai
Ukrainian
"Information is available in many languages in a screen reader accessible format."
documented · checked 2026-10-13 · Medical Financial Assistance Policy Summary
Sources
POLICY TITLE: Medical Financial Assistance — fetched 2026-10-13
Medical Financial Assistance Policy Summary — fetched 2026-10-13
Medical Financial Assistance Policy Summary — fetched 2026-10-13
download — fetched 2026-10-13