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Options for affordable health care in California

Hospital Fair Pricing

Typically, an uninsured or underinsured person who goes to a hospital is charged 3-5 times more than a big insurer would pay for exactly the same care.

California's Hospital Fair Pricing Act of 2006 limits the amount hospitals in California can charge patients who are either uninsured or underinsured and have high medical costs, and whose income is not higher than 3.5 times the Federal Poverty Level (FPL). 

Hospitals may not charge eligible patients more for care than they could charge Medicare.  In most cases, this amounts to a 65-85% discount below the inflated price that uninsured people usually have to pay.

Hospitals may offer Fair Pricing Act discounts to people with higher incomes, and many do.  Different hospitals also count income and expenses differently.  If you are uninsured and able to travel, you should be able to find a hospital that will give you a Fair Price discount somewhere in California. 

How to find a hospital that will give you a Fair Price

Step 1:
Figure out whether you are uninsured or underinsured with high medical costs. To be eligible for a Fair Price discount, you must fit into one of these two categories.
Step 2:
Estimate your FPL number.
Step 3:
Once you know your FPL number, go to the State of California's Hospital Fair Pricing website to find out if you're eligible for a Fair Price discount at any hospitals.
  • At the left of the screen, where it says Search Fair Pricing, click on "Distance" and select "500 miles" from the drop down menu.
  • In "From Location," type the name of the city where you live. Click "Search."
  • Scroll down until you see a list of hospitals. This list will show every hospital within 500 miles of you, with the highest FPL number you can have and be eligible for a Fair Price discount at that hospital.

For example, if your FPL number is 400, look at the hospitals on your list that have an FPL number of 400 or higher. These are the hospitals that should give you a Fair Price discount if you are uninsured or underinsured with high medical costs. Hospitals listed with an FPL number of 350 or lower will not give you a Fair Price discount on your bill, because your income is over their limit.

Step 4:
Choose the hospital you prefer. Factors to consider include location and quality of care, as well as cost.
Step 5:
Click on that hospital's name to go to its Hospital Details page.
  • Scroll down until you see the hospital's Fair Pricing Policy and Application form. Be sure to look at both the discount payment and the charity care materials, if they are different; some hospitals combine them in one document.
  • Print the application and fill it out. If there is anything on the application you don't understand, call the person listed as the Contact in the Hospital General Information section on the website, and ask them to explain it to you. If you can't find anyone at the hospital who can explain it to you, advocates at your local Health Consumer Center may be able to help you.
  • Mail or fax your application to the hospital. If you mail your application, send it Certified Mail and keep the receipt. If you fax it, keep a fax receipt to show you sent it. Keep a photocopy of your application and all supporting documents.

If your application for a Fair Pricing Act discount is denied and you wish to appeal, your local Health Consumer Center may be able to assist you.

Which bills are covered?

The Hospital Fair Pricing Act only covers bills from the hospital, not from doctors who may bill separately for services they provide in the hospital, such as surgeons and anesthesiologists. However, many providers will give a discount or forgive the bill if you cannot pay it, so you should try asking. If you have been given a Fair Price discount or free care from the hospital, be sure to say this when you ask the doctors. For information on overcharging of the uninsured by Emergency Room doctors, click here.