Medical Financial Assistance (MFA)

Agency: KAISER PERMANENTE NORTHERN CALIFORNIA

Description:

Helps qualified low-income, uninsured, and underinsured patients pay for eligible medical care they have already received from Kaiser Permanente or for emergency care they are currently seeking.

Medical Financial Assistance (MFA) is not an insurance plan; it’s intended as short-term support for patients who are unable to pay their portion of emergency or medically necessary care received at Kaiser Permanente.

Apply online at kp.org/mfa/ncal

Phone:

• MFA Number: 800-390-3507
• Member Services Number: 800-464-4000
• Fax: 800-687-9901
• TTY: 711

Email: National-Media-Relations@kp.org
Website: www.kp.org/mfa/ncal

Location(s)

Program Delivery

• Eligibility: Kaiser members or Patients who have already received care or are currently seeking emergency medical care and who are not able to pay and based on financial need. Household income is at or below 400% of the federal poverty level. Patients who have experienced unusually high out-of-pocket medical expenses may also be eligible, regardless of household income.
• Languages: Other languages available through the language line, English, Spanish
• Application Process: Telephone call or apply online at www.kp.org/mfa/ncal. Fax or mail application.
• Program Fees: Sliding; Discounts are determined by the patient’s household size and income as a percentage of the federal poverty level (FPL)
• Required Documents: Proof of income documents for all households: Recent W-2s, 1099 Statement(s) or Tax Returns, Pay Stubs, or Benefit Verification letter from Social Security Administration or Social Security Statement, Spousal/Child Support Payment (Monthly Gross Statement), Unemployment/Disability Benefits Verification Letter, VA Benefits Verification Letter, Government Assistance (Medi-Cal, TANF, SNAP, WIC, or Low-Income Housing) Approval Letter, or a Written Attestation/Explanation for No Income.

Service Area

• Defined Coverage Area: N/A