Financial Assistance

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

• 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