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Medical Financial Assistance

Kaiser Permanente’s Medical Financial Assistance (MFA) program provides financial assistance for qualifying patients who need help paying for emergency or medically necessary care they receive in a Kaiser Permanente facility by a Kaiser Permanente provider.  Patients must fill out an application (below) to apply and must meet the eligibility requirements listed below to qualify.

Who is eligible for Financial Assistance and what are the requirements?

The program helps low-income, uninsured, or underserved patients who need help paying for all or part of their medical care.  Patients are eligible for financial assistance when their family income is at or below 350% of the Federal Poverty Guidelines (FPG).  Evaluation of other criteria may be required.  Patients should consult with a Medical Financial Assistance Specialist to determine eligibility and for assistance applying.  Any patient who meets special circumstance criteria may be eligible for financial assistance.

Patients who are eligible for medical financial assistance will not be charged more than amounts generally billed (AGB) for emergency or other medically necessary care to patients with insurance (AGB, as defined by IRS Section 501(r)).

What does the program cover?

The Medical Financial Assistance program covers medically necessary care provided at a Kaiser Permanente medical office or pharmacy, and provided by a Kaiser Permanente physician or Kaiser Permanente provider.  The types of services not covered are premiums and dues; optical and hearing aids; cosmetic and non-urgent services.

How do I apply?

  • You may download an application here.  In addition to English, the application is available in Spanish and Vietnamese.

You may also request an application in these ways:

  • Call the Medical Financial Assistance Department at 1-301-816-6615 between 8:30 a.m. and 4:30 p.m., Monday through Friday.
  • Contact the Medical Financial Assistance Department or the Administration office at your local Medical Center Building.
  • Request an application by mail (at no cost) by sending a letter to Medical Financial Assistance, 2101 East Jefferson Street, Rockville, MD 20852-9468.

Please mail completed applications (including all required documentation and information specified in the application instructions) to 2101 East Jefferson Street, Rockville, MD 20852-9468, or deliver your application in person to your local Medical Center Building.

We will review submitted applications once they are complete.  We will determine whether you are eligible according to the Kaiser Permanente Medical Financial Assistance Policy. We will not consider incomplete applications, but will notify you and provide you an opportunity to send in the missing documentation or information by the required deadline.

Is there language assistance?

Interpreters are available to you at no cost.  The Medical Financial Assistance application, policy, and this policy summary may be available in your language.  For more information, call 1-301-816-6615.

How can I get a copy of Kaiser Permanente’s Financial Assistance policy? 

You may download here the policy that sets the requirements for Kaiser Permanente’s Medical Financial Assistance.  You may also request your free copy of the policy by calling 1-301-816-6615, or by mailing your request to 2101 East Jefferson Street, Rockville, MD 20852-9468.  A plain language summary of the policy is available here.   The plain language summary is also available in Spanish and Vietnamese.

Need help?

For help or questions about the Medical Financial Assistance application process, please call 1-301-816-6615, or speak to a MFA Specialist within the MFA Department or the Administration office at your local Medical Center Building.