A Kaiser bill doesn’t have to be the final number you pay. The Medical Financial Assistance program covers far more than most patients realize — including prescription costs, behavioral health, and the copays and deductibles of people who already have coverage. Here is everything you actually need to know to get help.
Kaiser Permanente’s financial assistance program goes significantly underused because most patients don’t know it exists, assume they earn too much, or believe it only helps the uninsured. None of those assumptions are accurate. These are the questions that come up most, answered directly.
1 I have Kaiser insurance — can I still get financial assistance for my copays and deductible? Yes. This is the most widely missed benefit. Kaiser’s MFA program applies to members’ copays, coinsurance, and deductible payments — not just to uninsured patients’ total bills. ▼
2 I’m not a Kaiser member — I went there for an emergency. Can I still apply? Yes. The MFA program is open to non-members who received emergency or medically necessary care at a Kaiser facility. The income and documentation requirements are the same. ▼
3 My income is too high for the standard limit — am I automatically out? Not necessarily. There’s a second eligibility pathway: if your out-of-pocket Kaiser costs in the past 12 months equal 10% or more of your gross annual income, you may qualify regardless of your income level. ▼
4 Does Kaiser’s financial assistance cover prescriptions? Yes — and this is unusual. Most hospital charity care programs only cover hospital bills. Kaiser’s program also covers prescriptions filled at Kaiser pharmacies because it operates as an integrated system. ▼
5 Will Kaiser send my bill to collections while I’m applying? No. Once you submit a Medical Financial Assistance application — even an incomplete one — all extraordinary collection actions are paused while the application is under review. ▼
6 How long do I have to apply after I received care? Typically up to 240 days from your first billing statement. Don’t assume it’s too late — even for older bills, it’s worth calling Patient Financial Services to confirm your specific window. ▼
7 I don’t have Kaiser insurance at all. Is there a program for ongoing coverage, not just one bill? Yes — the Community Health Coverage Program (CHCP) provides subsidized ongoing Kaiser coverage with no monthly premiums and no copays for qualifying uninsured adults under 300% of the Federal Poverty Level. ▼
8 Does Kaiser’s MFA program cover mental health and therapy appointments? Yes — behavioral health services provided at Kaiser facilities are covered under MFA. This includes therapy, psychiatry visits, and mental health prescriptions ordered by Kaiser providers. ▼
Kaiser’s MFA program is their primary financial safety net. It’s unusually comprehensive compared to most hospital charity care programs — covering not just emergency hospital bills but also prescriptions, behavioral health, and the cost-sharing of insured members. Understanding the full scope is the first step.
Income limits are based on total gross household income before taxes and deductions, compared against the Federal Poverty Guidelines. The thresholds vary slightly by region, so the numbers below are general guidelines — always confirm with your regional Patient Financial Services office.
| Household Size | 300% FPL (Free Care) | 350% FPL (Some Regions) | 400% FPL (Discount) |
|---|---|---|---|
| 1 person | ~$47,880/yr | ~$55,860/yr | ~$63,840/yr |
| 2 people | ~$64,680/yr | ~$75,460/yr | ~$86,240/yr |
| 3 people | ~$81,480/yr | ~$95,060/yr | ~$108,640/yr |
| 4 people | ~$98,280/yr | ~$114,660/yr | ~$131,040/yr |
| 5 people | ~$115,080/yr | ~$134,260/yr | ~$153,440/yr |
| 6 people | ~$131,880/yr | ~$153,860/yr | ~$175,840/yr |
These figures are approximate based on current Federal Poverty Guidelines. Some California regions use 350% FPL for the free care threshold. The Discount Payment Program applies to incomes between 351% and 400% FPL in some regions. Verify the exact numbers for your specific region at kp.org/mfa. Income figures are gross (before taxes).
Even if your income is above these thresholds, you may still qualify through the high-expense pathway: if your total out-of-pocket costs for emergency or medically necessary care, dental care, and prescriptions at Kaiser facilities over any 12-month period equal 10% or more of your annual gross household income, you can apply. There is no income cap on this pathway. Document every out-of-pocket expense with receipts or itemized statements before applying.
- Emergency and urgent care — including ER visits, crisis services, and medically necessary urgent treatment
- Medically necessary health care services — inpatient hospitalizations, surgery, imaging, lab work, specialist visits
- Pharmacy services and prescriptions — medications dispensed at Kaiser outpatient pharmacies, ordered by Kaiser providers
- Behavioral health services — therapy, psychiatry, substance use treatment, mental health medications
- Medical supplies — supplies provided at Kaiser hospitals, medical centers, and offices
- Member cost-sharing — copays, coinsurance, and deductibles for insured Kaiser members on qualifying services
- Non-Kaiser providers — bills from outside physicians, labs, or hospitals, even if a Kaiser doctor referred you there
- Cosmetic procedures — elective cosmetic surgery and cosmetic services not deemed medically necessary
- Infertility treatments — fertility services, IVF, and related procedures
- Surrogacy-related services
- Workers’ compensation or third-party liability cases — injuries covered under workers’ comp or where a third party is responsible
- Retail medical supplies — over-the-counter items and retail-category supplies not provided through Kaiser
- Prescriptions filled at outside pharmacies — even if prescribed by a Kaiser doctor
The CHCP is an entirely different program from MFA. Instead of helping with a single bill, it provides actual health plan coverage to uninsured people who qualify — with no monthly premium and minimal out-of-pocket costs for care at Kaiser facilities.
Adults over 21 can receive the CHCP subsidy for a maximum of three consecutive years. After that period, if you skip even one renewal year, you permanently lose future eligibility. The CHCP should be treated as a bridge to permanent coverage — use those three years to establish Medicaid eligibility, find employer coverage, or enroll through the marketplace. The Mid-Atlantic region (Maryland, Virginia, D.C.) has met its capacity for the current enrollment period and is not accepting new applications — check charitablehealth.kaiserpermanente.org for updates on when enrollment may reopen.
Kaiser operates as separate regional entities, and your application form, phone number, and specific eligibility rules all depend on where you received your care. Using the wrong region’s form slows your application significantly.
| Region | States Served | MFA Phone | Application URL |
|---|---|---|---|
| Northern California | Northern & Central CA | 1-866-399-7696 | kp.org/mfa/ncal |
| Southern California | Southern CA | 1-800-390-3507 | kp.org/mfa/scal |
| Colorado | Colorado | 1-877-799-4700 | kp.org/mfa/co |
| Georgia | Georgia (Atlanta area) | 1-877-699-7407 | kp.org/mfa/ga |
| Hawaii | Hawaii (Oahu & Maui) | 1-877-578-2700 | kp.org/mfa/hi |
| Mid-Atlantic | Maryland, Virginia, D.C. | 1-800-777-7902 | kp.org/mfa/mas |
| Northwest | Oregon, SW Washington | 1-877-729-5590 | kp.org/mfa/nw |
| Washington | Washington State | 1-844-632-2045 | kp.org/mfa/wa |
TTY/TDD users: dial 711 and ask the relay service to call the number for your region. If you received care in a Kaiser state you don’t live in, use the region where the care was provided. Phone hours vary by region — most are Monday through Friday, 8 a.m. to 5 p.m. local time.
Beyond financial assistance for bills, Kaiser maintains a Community Support Hub for connecting patients to help with food, housing, utilities, and other social needs — all confidential and at no cost regardless of immigration status. Call 1-800-443-6328 (TTY 711), Monday through Friday, 8 a.m. to 5 p.m., or visit kp.org/socialhealth.
The application is free to submit and there is no charge to apply. Beware of any third party that offers to submit your MFA application for a fee — that is never necessary. Kaiser’s process is designed so patients can navigate it without outside help.
The most common reason applications are delayed or denied is missing income documentation. Collect these before starting: most recent federal tax return or W-2, last two to three pay stubs, and any benefit award letters (Social Security, disability, pension). If you had no income in the most recent tax year, write a brief statement explaining that. If your situation is the high-expense pathway rather than the income pathway, gather 12 months of itemized receipts or billing statements showing your out-of-pocket costs. Having everything in hand before you open the application cuts completion time from an hour to about 15 minutes.
The quickest way to apply is through the online portal at kp.org/mfa. Enter your region, create or sign into your Kaiser account, and complete the secure online form — you can upload documents directly. Four methods are available: online at kp.org/mfa (fastest), by mail to the regional PO box on your application form, by fax to your region’s fax number, or in person at any Kaiser Permanente medical center’s patient financial services desk. In-person applications allow a patient financial advisor to help you complete the form on the spot. No matter which method you choose, request a confirmation — a number, a receipt, a timestamp — so you have proof that your application was submitted if questions arise later.
Kaiser’s application notes this explicitly: incomplete applications are the leading cause of processing delays and denials. Fill in every field. List every household member even if they have no income. If a field asks for income sources you don’t have, write “none” rather than leaving it blank. If you’re applying under the high-expense pathway, use the out-of-pocket expense section to list all qualifying costs with dates and amounts, and attach copies of receipts or statements. Do not round or estimate income — use exact figures from your documentation. Inconsistencies between your stated income and your uploaded documents are the second most common cause of delays.
Kaiser will notify you of their decision by mail within approximately 30 days of receiving a completed application. The letter will confirm approval, explain the award amount and period, or provide a denial reason. If you are approved, the assistance is applied directly to your account — you do not receive a check. If 30 days pass without a letter, call your regional Patient Financial Services number to check the status of your application. Providing your submission confirmation and the date you applied will help the representative locate your case quickly. Keep copies of everything you submitted; if a document was somehow not received, you can resubmit without redoing the entire application.
MFA approval is not permanent. If you need ongoing assistance, you must renew your application annually. Kaiser will send you renewal forms, but do not wait for that mailing if your eligibility period is approaching its end — proactively contact Patient Financial Services and ask about renewal timing for your region. Missing a renewal window can result in a lapse in coverage of your cost-sharing, leaving you responsible for bills that would have been covered. Set a calendar reminder 30 days before your award’s expiration date so you have time to gather updated income documents and resubmit.
A denial is not necessarily final. Kaiser’s own policy provides an appeal pathway, and there are additional options even after an internal appeal is exhausted. Understanding each step protects your rights and your finances.
The denial letter should include an explanation, but if it’s vague, call Patient Financial Services and ask for a specific written explanation of why your application was denied. The reason matters — a missing document denial is correctable immediately; an income-based denial may require a different approach. Do not accept a denial without understanding the exact basis for it.
Kaiser’s own policy provides a formal appeal pathway. You can start an appeal online at Kaiser’s appeal page (healthy.kaiserpermanente.org/mfaprogram-appeal) by submitting your name and email — you’ll receive instructions by email on how to file. The appeal allows you to provide additional documentation or explain circumstances that weren’t captured in the original application. If you have evidence of high out-of-pocket costs from the past year, the appeal is the place to present them. Appeal decisions are communicated in writing.
Some Kaiser regions have a “catastrophic hardship” provision separate from standard MFA eligibility. If your financial situation is extreme — significant assets depleted by medical costs, impending bankruptcy, inability to cover basic living expenses due to medical bills — ask Patient Financial Services specifically whether this provision applies in your region. It is not always listed in standard program materials.
Even if financial assistance is denied entirely, Kaiser offers payment plans that are typically interest-free. Never put a Kaiser bill on a credit card before asking about a no-interest payment plan — the interest charges that would accumulate on a credit card far exceed any convenience. Ask specifically for a monthly payment that fits your actual budget. Kaiser patient financial counselors can also help you explore whether Medicaid, Covered California, or another public program might cover the charges going forward.
Several states where Kaiser operates have medical billing laws that go beyond what the federal IRS charity care rules require. California’s Hospital Fair Pricing Act, for example, requires hospitals to offer discounts or free care at thresholds that may be more generous than Kaiser’s standard MFA thresholds. Oregon and Washington have their own protections as well. If you believe you were improperly denied, contact your state’s hospital licensing or insurance regulatory agency — Kaiser is obligated to respond to formal complaints through those channels.
Do not pay it and do not ignore it — apply for MFA first. Go to kp.org/mfa, select your region, and submit the application online as soon as possible. Submitting the application — even an incomplete one — pauses collection actions. While you’re applying, call Patient Financial Services at your regional number and let them know you’ve submitted. If the bill is already in collections, apply anyway and call immediately — apply the same day you call. Do not assume the 240-day window has closed without confirming it with a representative. Once you submit, you have also preserved your rights under the “amounts generally billed” rule, which means Kaiser cannot charge you more than what they charge insured patients for the same services.
Apply for MFA at kp.org/mfa — this is what most insured Kaiser members don’t know. If your household income is within the eligibility range, your copays, coinsurance, and deductible payments on qualifying services can be reduced or eliminated through the same program that helps uninsured patients. Gather your explanation of benefits statements and most recent pay stubs before applying. If your income is above the standard threshold, calculate whether your past 12 months of out-of-pocket Kaiser costs exceed 10% of your annual gross income — the high-expense pathway may apply regardless of your income level. A Kaiser patient financial advisor at any medical center can walk through the math with you at no charge.
Kaiser’s MFA program covers medications dispensed at Kaiser outpatient pharmacies that are ordered by Kaiser providers. If you meet the income or high-expense eligibility criteria, your out-of-pocket prescription costs can be covered under the same MFA award that addresses your other Kaiser bills — you don’t need a separate application. Call your regional Patient Financial Services number and ask specifically about prescription coverage under MFA for your region. Also ask your Kaiser pharmacist whether any manufacturer patient assistance programs apply to your specific medications — Kaiser pharmacists can sometimes facilitate access to these programs directly.
The Community Health Coverage Program (CHCP) is what you’re looking for. Go to charitablehealth.kaiserpermanente.org and check your region’s eligibility. If you live in California, Colorado, Hawaii, Oregon, or Washington, enrollment may be open. The Mid-Atlantic region is currently at capacity. Income must be at or below 300% of the Federal Poverty Level, and you must not have access to other coverage. Adults over 21 receive the subsidy for up to three years — use that window to establish a pathway to permanent coverage. Also apply for MFA on any existing bills at kp.org/mfa — the two programs can be used together if you qualify for both.
Mental health therapy, psychiatry visits, and substance use treatment at Kaiser facilities are all covered under MFA — this includes the copays for insured members who meet income eligibility, not just uninsured patients. Apply at kp.org/mfa and include your behavioral health bills in the out-of-pocket expenses section. If you’re uncertain whether you qualify by income, check whether your total out-of-pocket Kaiser costs in the past 12 months (including behavioral health copays) exceed 10% of your gross income. Call the Kaiser Community Support Hub at 1-800-443-6328 if you also need help with related social factors like housing or food insecurity that are affecting your mental health — that service is separate from MFA and available to all Kaiser patients.
Apply immediately, even now. The 240-day window is measured from your first billing statement — if you’re still within that period, submit the MFA application today through kp.org/mfa. Call Patient Financial Services at your regional number on the same day and explain that the account is in collections and you are actively submitting an application. They are required to pause extraordinary collection actions once an application is received. If you are outside the 240-day window, call Patient Financial Services anyway and explain your circumstances — some regions have case-by-case provisions for extraordinary financial hardship that extend the application window. Also contact a HUD-approved housing counselor or a legal aid organization if the debt has reached a point where it’s threatening your housing or wages.
This guide is for informational purposes only and is not affiliated with, sponsored by, endorsed by, or produced in partnership with Kaiser Permanente. Program details, income thresholds, eligibility rules, regional differences, phone numbers, and application processes are subject to change. Always verify current information directly with Kaiser Permanente’s Patient Financial Services for your specific region before applying. Kaiser Permanente regional policies may vary. Nothing in this guide constitutes medical, legal, or financial advice. Kaiser Permanente and KP are registered trademarks of Kaiser Foundation Health Plan, Inc.