Having trouble paying for your Kaiser Permanente medical and pharmacy expenses?

Kaiser Permanente is committed to providing programs that facilitate access to care for vulnerable populations. This commitment includes providing financial assistance to qualified low-income, uninsured, and underinsured patients when the ability to pay for services is a barrier to accessing emergency and medically necessary care. Patients must meet the eligibility requirements below to qualify.

 

Who is eligible for Financial Assistance and what are the requirements?

The Medical Financial Assistance (MFA) program helps low-income, uninsured, and underinsured patients who need help paying for all or part of their medical care received from Kaiser Permanente and Kaiser Permanente network providers. Patients are eligible for financial assistance when their family income is at or below 300 percent of the Federal Poverty Guidelines (FPG). Patients should consult with a counselor to determine eligibility and for assistance applying. Patients who have experienced unusually high medical expenses may be eligible for the program, regardless of household income. Refer to the MFA Policy for a complete description of the program eligibility requirements.

 

What does the program cover?

The MFA program covers emergency and medically necessary health care services, pharmacy services and products, and medical supplies provided at Kaiser Permanente medical offices, at Kaiser Permanente outpatient pharmacies, or by Kaiser Permanente network providers. Services that are not considered emergent or medically necessary as determined by a Kaiser Permanente provider include, but are not limited to cosmetic surgery or services, infertility treatments, retail medical supplies, surrogacy services, and services related to third party liability, or workers’ compensation cases. Refer to the MFA Policy for a complete list of eligible and ineligible services.

 

How can I get program information?
Copies of the MFA policy, application forms, instructions, and plain language summaries (e.g. policy summaries or program brochures) are available without charge, from Kaiser Permanente’s website, by email, in person, by telephone, or by U.S. postal mail.

 

Download program information:
Electronic copies of program information are available. Click the links below to download.
Medical Financial Assistance Policy

Medical Financial Assistance Policy in Spanish

Program Summary

Program Application

Program Application in Spanish

 

Request program information electronically:
Electronic copies of program information are available by email upon request, call 1-866-899-6018. Please be prepared when calling to provide an email address to receive the information.

 

Obtain program information in person:
Counselors are available at the Patient Registration Department in each Kaiser Permanente medical office building to provide program information and to quickly determine MFA eligibility.

 

Request program information by telephone:
Counselors are available by telephone to provide information, determine MFA eligibility, and assist a patient to apply for MFA. Counselors can be reached at:
303-338-3555, or 1-866-899-6018, or TTY: 1-800-659-2656; Monday – Friday, 8:00 a.m. to 5:00 p.m.

 

Request program information by U.S. postal mail:
A patient can request program information by mail.
Kaiser Permanente
Attention: Medical Financial Assistance Department
P.O. Box 378066
Denver, Colorado 80237

 

How do I apply?

A patient can apply for the MFA program, during or following the care received from Kaiser Permanente, in several ways including in person with a counselor, or by submitting a complete paper application.

 

Apply in person:
Counselors are available to quickly determine MFA eligibility at the Patient Registration Department in each Kaiser Permanente medical office.

 

Complete and submit a program application:
Please mail completed applications (including all required documentation and information specified in the application instructions) to:
Kaiser Permanente
Attention: Medical Financial Assistance Department
Water Park 1 Building
2500 South Havana Street
Denver, Colorado 80014

Kaiser Permanente will review submitted applications when they are complete and will determine whether you are eligible according to the Kaiser Permanente Medical Financial Assistance Policy. Incomplete applications may result in a delay in processing or denial of your MFA application; Kaiser Permanente will notify applicants and provide an opportunity to send in the missing documentation or information, by the required deadline.

 

Amounts Generally Billed

Amounts Generally Billed (AGB) is based on the lowest average of the amounts that were paid to Kaiser Permanente by private health insurers, Medicare fee-for-service, and Medicaid fee-for-service (and co-pays and deductibles) for emergency or medically necessary services, based on actual claim data from November 1, 2014 to October 31, 2015, which is consistent with the look-back method. The 2016 AGB reduction to gross charges is 22 percent.

 

Is language assistance available?
Interpreters are available at no cost. The Medical Financial Assistance application, policy and the policy summary may be available in your language. For more information, call 1-866-899-6018 (TTY: 1-800-659-2656).

 

Other beneficial programs and resources

If you don’t have health care coverage and would like more information, visit healthcare.gov or call 1-800-318-2596.

This may be a hard time for you financially. If you need help paying for needs other than health care, there are community resources and programs that can help. For more information on programs that may save you money, visit myadvocatehelps.com. Examples include:

  • Food stamps through the Supplemental Nutrition Assistance Program (SNAP)
  • Local food pantries and community centers
  • Transportation assistance

 

Need help?

For help or questions about the Medical Financial Assistance application process or other questions, please call 1-866-899-6018 (TTY: 1-800-659-2656), or speak to a financial counselor or patient registration associate, in the patient registration department at your local Kaiser Permanente medical office.

Files:

MFA Policy
MFA Policy Summary
MFA Application
MFA Policy_Spanish
MFA Application_Spanish
Amounts Generally Billed

This website is for informational purposes only. The information provided within this website is subject to change. Nondiscrimination Notice.