Help Paying Your Bill

What if I can’t afford to pay my bill?

Financial Assistance Program

The Business Office offers financial assistance through our Charity Care and Discount Payment Program. If you have any questions, please call the Business Office (831) 636-2620.

For instructions on how to apply, please open the application links below.

Policies: Click link to view policies

Financial Assistance Program Guideline:

Financial Assistance Applications:

Providers Who Bill Separately

It is important to remember that your bill covers services provided by the hospital such as your room, nursing care, meals, housekeeping, and linen. It may also include services ordered by your physician such as X-rays, laboratory tests, medical supplies, and oxygen. The bill does not include charges for your personal physician, hospitalist, surgeon, anesthesiologist, pathologist, emergency physician, radiologist, etc. You will receive separate bills from these physicians for their services.

Cash Pay/Uninsured Patients Discounted Rates

Medical care is not out of reach for those individuals without insurance coverage. We offer discounted cash pay services and accept major credit cards at time of service. Please call the Business Office at (831) 636-2620 to discuss our discounted cash pay services.

Patient Financial Assistance Program Guidelines:

This program provides financial assistance to persons who have health care needs, are uninsured, and are ineligible for any government programs.

Eligibility Requirements:

INCOME MUST NOT EXCEED 400% OF THE MONTHLY FEDERAL POVERTY LEVEL: See below

Family size:	May not exceed monthly income:
1	$4,294
2	$5,807
3	$7,320
4	$8,834
5	$10,347

IN ORDER FOR US TO CONSIDER YOUR REQUEST, YOU MUST MEET THE GUIDELINES BELOW:

Patients with accounts over $500.00 ·
Patient with high medical cost that exceed 10% of family income ·
Patient accounts that are Emergent, Inpatient, or Observation. ·
Patient has up to 180 days to apply after the initial bill.

The Financial Assistant Program will NOT cover:

Elective Procedures will not be considered for Charity Care but will qualify for the Self-Pay Rate or discount according to the policy. Elective Procedures include Outpatient Surgeries, Therapy, Lab Services, Radiology Services including Ultra Sound, MRI’s, CT’s, and Skilled Nursing.
Medi-Cal Share of Cost

NOTE: If you feel you may meet the financial guidelines of the Financial Assistant Program please contact the Business office at (831) 636-2620 or click on the links below to obtain the complete Financial Assistant application.

If you have questions, please call our Business Office at 831-636-2620 or (831) 636-2622.

Send or return your completed application to:

Hazel Hawkins Memorial Hospital
Patient Financial Services Department
911 Sunset Drive
Hollister, CA 95023

Hospital Bill Complaint Program:

The Hospital Bill Complaint Program is a state program, which 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. Go to HospitalBillComplaintProgram.hcai.ca.gov for more information and to file a complaint.