Help Paying Your Bill

Eligibility Information

To be eligible for the Charity Care Program:

• the patient’s family household income may not exceed 500% of the federal poverty level; and
• the patient’s family qualified assets may not exceed $250 at time of service

To be eligible for the Discount Payment Program:

• the patient is not eligible for the Charity Care Program
• the patient’s household federal poverty level determines the amount of the discount to be applied

How to Apply for Financial Assistance

SFDPH has a single application for both of the Charity Care and Discount Payment programs.  Each program has different eligibility requirements, as described below. Patients must provide a completed application and all required verification.

• You must submit a complete application within 12 months from the date of when you received medical care.
• Verification required by each program must be submitted within 30 days of starting an application.
• You may mail an application to the following address: Zuckerberg San Francisco General Hospital, Patient Financial Assistance Department 1001 Potrero Ave, Building 20, San Francisco, CA 94110

Charity Care and Discount Payment Assistance Applications and Policy

Need Assistance?

Patients may contact the Patient Financial Services Eligibility Department for assistance by:

• Calling 628 206 3275 – Monday – Friday 8:00 a.m. – 11:30 a.m. and 1:00 p.m. – 5:00 p.m.
• Sending a message in the request financial assistance section of the patient’s MyChart patient portal account

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.