Financial Assistance

Huntington Hospital is committed to making health care available to everyone in our community, regardless of their ability to pay. Our financial assistance program helps low-income, uninsured or under-insured patients who need help paying for all or part of their medically necessary care.

Do I qualify?

You can request financial assistance if your income is at or below 350% of the Federal Poverty Guidelines, and you do not meet the qualifications for Medicaid.

How do I request financial assistance?

You can request financial assistance by completing an application and submitting certain documents. Our forms can be downloaded below in a variety of languages. To get a paper application, get help applying, or learn more about our policy, you can:

  • Talk to someone business office between 8am and 4pm, Monday to Friday, by calling (626) 397-5324 (translation services available). You can leave a message after hours.
  • Send a request by mail to 100 W. California Boulevard, Pasadena CA 91105
  • Visit our HelpHub in the main lobby of the hospital between 7:00 a.m. - 6:00 p.m., Monday through Friday, or go to any inpatient, outpatient or emergency patient admitting area.

Financial Assistance Forms

Get the application online here. We provide the application and policy in the most commonly requested languages.

Summary of Financial Assistance Policy

Financial Assistance Application

Financial Assistance Policy

FAP Appendix A

FAP Appendix B

Patient Collections Policy

If you do not have Adobe Acrobat Reader, you may download it free from the Adobe® website, by clicking on the link below:

Get Adobe Reader

For questions regarding this form, please call: (626) 397-5324

Additional Information

Financial Counselors
Huntington Hospital has financial counselors on hand to evaluate your eligibility for various local and state Programs, including County Assistance and Medicaid.

Uninsured Discount Policy
For patients who do not meet the Financial Assistance Discount Policy criteria and will be expected to pay for services out of pocket, Huntington Hospital offers a discount similar to that received by managed care health plans. All Uninsured patients (excluding those receiving cosmetic procedures and certain "package" procedures) will be given an Uninsured Discount. All pricing estimates posted under the “Uninsured” insurance type already reflect the hospital's uninsured discount. To access our full Uninsured (Self-Pay) Policy, click here.

Similar to when you visit your physician's office, we expect payment at time of service. If you are ineligible for Medicaid or Financial Assistance and cannot pay your entire bill, we will work with you to set up monthly payment arrangements. If, after your services are received, any additional payment is due, we will send you information about any amount you may still owe. We accept major credit cards, checks, money orders and cash. You may also pay your bill online.

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