Santa Clara Valley Medical Center
Acute care hospital in San Jose, CA.
Verified from the hospital's own policy
Santa Clara Valley Medical Center likely gives free care to households with a yearly income up to $63,840 for 1 person, $86,560 for 2, $109,280 for 3, $132,000 for 4, $154,720 for 5 or $177,440 for 6. It likely gives a discount to households with a yearly income up to $103,580 for 1 person, $140,444 for 2, $177,307 for 3, $214,170 for 4, $251,033 for 5 or $287,896 for 6.
The hospital makes the final decision.
| People in household | Free care up to | Discount up to |
|---|---|---|
| 1 | $63,840 | $103,580 |
| 2 | $86,560 | $140,444 |
| 3 | $109,280 | $177,307 |
| 4 | $132,000 | $214,170 |
| 5 | $154,720 | $251,033 |
| 6 | $177,440 | $287,896 |
Discount steps
- 0% to 400% of poverty level, you pay $0 (100% Charity Care)
- 401% to 449% of poverty level, you pay 30% of the bill (70% discount), County residents
- 450% to 549% of poverty level, you pay 50% of the bill (50% discount), County residents
- 550% to 649% of poverty level, you pay 75% of the bill (25% discount), County residents
How to apply
- Call (866) 967-4677 and ask for financial assistance.
- Application form
- Healthcare Access Program (CSCHS #715.0; last updated December 12, 2024)
- Bring proof of identity, proof of income (recent tax returns or recent pay stubs), proof of Santa Clara County residency, for one-year help, proof of medical expenses paid in the past 12 months, if applying as a high medical cost patient.
- We do not have the deadline yet. Apply as soon as you get a bill, and ask the billing office to pause collections while you apply.
- Residency
- Santa Clara County residents get one year of help and the 401% to 649% discounts. Non-residents can get free care up to 400% for a single episode of care only.
- Savings and property
- The policy looks at income only, not savings or property.
- Very large bills
- Insured patients whose out-of-pocket costs are over 10% of family income count as High Medical Cost patients and get the same help as uninsured patients
If you have insurance
Insured patients can also apply for help with deductibles and copays. Keep your insurance. Financial assistance covers bills from this one place only.
What is covered
- Covered
- Medically necessary services and supplies from County of Santa Clara Health System providers, including Santa Clara Valley Medical Center, O'Connor Hospital, St. Louise Regional Hospital, and County clinics
- Not covered
- Separately billed physician fees and ambulance rides not requested by the County are not covered. Infertility, cosmetic, vision correction, patient-requested ambulance, and lifestyle medications are generally not covered.
State program in California
Hospital Fair Pricing Act (Health and Safety Code 127400 et seq.)
Every licensed general acute care, acute psychiatric, and special hospital in California must have a charity care policy and a discount payment policy. A patient can ask for help if they are uninsured (self-pay) or have high medical costs, and their family income is not more than 400% of the federal poverty level. Hospitals may choose to help people with higher incomes. With a discount, the bill is capped at about what Medicare or Medi-Cal would pay, whichever is greater. You can apply at any time, even after a bill goes to collections. Immigration status does not affect eligibility.
Income levels in the program are discount up to 400% of poverty level.
Applies to each licensed general acute care hospital, acute psychiatric hospital, and special hospital in California.
Apply to the hospital's financial assistance office. Each hospital's policies and applications are posted on its website and on HCAI's Hospital Fair Pricing Policy Lookup (https://hcai.ca.gov/affordability/hospital-fair-billing-program/hospital-fair-pricing-policy-lookup/).
Is a self-pay patient OR a patient with high medical costs; AND Patient's family income is not more than 400 percent of the federal poverty
Program source, checked 2026-11-10
Hospital Bill Complaint Program (HCAI)
A free state program at HCAI. If a hospital wrongly denied you financial assistance, did not tell you about its programs, or sent you to collections the wrong way, you can file a complaint online (English and Spanish) or by mail (many languages). You must have applied to the hospital first for HCAI to review an eligibility decision. If HCAI finds you paid too much, the hospital must refund you within 30 days. It covers problems on or after January 1, 2022. It does not handle general billing disputes, price transparency, Good Faith Estimates, or bills from emergency room doctors.
Applies to complaints about any hospital covered by the Hospital Fair Pricing Act.
File online through the Patient Complaint Portal (https://hcai.ca.gov/affordability/hospital-fair-billing-program/hospital-bill-complaint-program/should-i-file-a-complaint/) or mail the Patient Complaint Form to Department of Health Care Access and Information, Hospital Bill Complaint Program, 2020 West El Camino Avenue, Suite 1101, Sacramento, CA 95833.
If you believe you were wrongly denied financial assistance, you may file a complaint with the Hospital Bill Complaint Program.
Program source, checked 2026-11-10
Emergency physician discount rule
Most hospital policies cover only the hospital's own bill. Emergency room doctors often bill separately. California law also requires an emergency physician to give discounts to uninsured patients and patients with high medical costs whose family income is at or below 400% of the federal poverty level. Ask the doctor group's billing office for its discount policy. HCAI's complaint program does not handle emergency doctor bills.
Income levels in the program are discount up to 400% of poverty level.
Applies to emergency physicians who provide emergency medical services in a California hospital that provides emergency care.
Ask the emergency physician group named on the bill for its discount payment policy.
an emergency physician who provides emergency medical services in a hospital that provides emergency care is also required by law to provide discounted care
Program source, checked 2026-11-10
Notes
Free care if your family income is at or below 400% of the poverty level. Santa Clara County residents with higher incomes get 70% off from 401% to 449%, 50% off from 450% to 549%, and 25% off from 550% to 649%. Insured patients with out-of-pocket costs over 10% of family income get the same help. Savings and other assets are not counted. County residents get help for one year and must reapply each year. People who do not show proof of County residency can get free care up to 400% for one visit or hospital stay at a time. The application says proof of residency is not required for charity care or a discount, which reads differently from the policy. The policy sets no deadline to apply. Decisions come within 30 days. Appeals go in writing within 30 days to the Revenue Cycle Director, 5750 Fontanoso Way, 1st Floor, San José, CA 95138, then to the Chief Financial Officer. The appeals section lists (877) 967-4677 while the rest of the policy lists (866) 967-4677. This one policy replaced the old VMC Sliding Scale and Ability to Pay Determination programs.
Sources
- Free care level
Charity Care: Free care (which is available to eligible patients with family incomes at or below 400% of the Federal Poverty Level
- Discount level
available to eligible patients with family incomes above 400% but below 650% of the Federal Poverty Level
- Discount steps
Family Income between 550% – 649% of 25% Discounted Payment
- Insured patients
Has a third-party source of payment for healthcare services (i.e., is not a Self-Pay Patient), and
- Asset test
The County does not consider a patient’s assets when determining eligibility for Charity Care or a Discounted Payment.
- Residency
Eligible Non-County Residents may only qualify for Charity Care for a specific Episode of Care, not on an ongoing, one-year basis.
- Very large bills
Incurred annual out-of-pocket healthcare costs at the County that exceed the lesser of 10% of the Patient’s current Family Income
- What is not covered
for separately billed physician professional fees, or for ambulance transportation not requested by the County.
- Documents
Proof of identity (for example, a driver’s license, passport, government- issued ID card, work or school ID card
- Financial counseling phone
contact Patient Financial Services at (866) 967-4677 (TTY: 711) (Monday to Friday, 8am to 5pm)
Last checked. 2026-11-10
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