# Scripps Memorial Hospital La Jolla

Hospital in La Jolla, CA. Verified from the hospital's own policy.

Scripps Memorial Hospital La Jolla likely gives free care to households with a yearly income up to $39,900 for 1 person, $54,100 for 2, $68,300 for 3, $82,500 for 4, $96,700 for 5 or $110,900 for 6. It likely gives a discount 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.

The hospital makes the final decision.

| Household size | Free care if yearly income is up to | Discount if yearly income is up to |
|---|---|---|
| 1 | $39,900 | $63,840 |
| 2 | $54,100 | $86,560 |
| 3 | $68,300 | $109,280 |
| 4 | $82,500 | $132,000 |
| 5 | $96,700 | $154,720 |
| 6 | $110,900 | $177,440 |

Dollar amounts use the 2026 federal poverty guidelines.

## Discount steps

- 0% to 250% of poverty level, patient pays charity care: full or partial forgiveness of the patient share (the application calls this full help)
- 251% to 400% of poverty level, patient pays discounted care: a reduced amount, never more than the amount generally billed

## How to apply

- Call (858) 927-5902 and ask for financial assistance.
- [Application form](https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=8acb6662-b5cb-426b-9ce6-cbae0c5bed24)
- [Financial Assistance, Billing and Collections (Including Charity and Discounted Care) (FAP), S-FW-LD-5421, effective 07/28/26](https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e9f313d3-75a8-4b35-a0c0-5a65c8fe3c6d)
- 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.
- Bring a recent pay stub or a recent income tax return (other papers are optional).
- Savings and property. The policy counts savings or property, not only income.
- Very large bills. Patients whose documented out-of-pocket medical costs in the past 12 months are over 10% of family income. Patients above 400% may be considered for catastrophic medical costs with management approval.

## 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. Emergency and medically necessary care at Scripps hospitals. Services in the hospital are presumed medically necessary.

Not covered. Physicians bill separately as independent contractors. Emergency physicians must give their own discounts up to 400% of the poverty level. Care that is not medically necessary is reviewed case by case.

## 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.

How to apply. 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

Source https://hcai.ca.gov/affordability/hospital-fair-billing-program/hospital-bill-complaint-program/frequently-asked-questions/, 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.

How to apply. 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.

Source https://hcai.ca.gov/affordability/hospital-fair-billing-program/hospital-bill-complaint-program/, 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.

How to apply. 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

Source https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=c7bdd7eb-bcc0-4a84-bcab-a21b5e578d9c, checked 2026-11-10

## Notes

This Scripps Health policy names Scripps Memorial Hospital La Jolla. Free or nearly free care at or below 250% of the poverty level. The policy says full or partial forgiveness, and the application calls it full help. Between 251% and 400%, you can get a discount and will not pay more than the amount insurers generally pay. Above 400%, Scripps may still help for hardship or very large medical bills, with manager approval. Insured patients with high costs can apply too. If your insurer already paid the generally billed amount, you owe no more copays or deductibles for that service. Scripps counts only health savings accounts. Your home, car and savings are not counted. The policy sets no deadline to apply. It asks you to send papers within 30 days when you can. Charity care may require you to apply for Medi-Cal or other coverage. The discount does not. You should get an answer within 20 business days of a complete application. Approval lasts 365 days. You can appeal a denial through the Scripps Business Office or call the Revenue Cycle Manager at (858) 927-5115. The phone number is the Scripps Financial Assistance Department. Scripps financial counselors are also at 1-877-727-SCRIPPS.

## Sources

- Free care level https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=8acb6662-b5cb-426b-9ce6-cbae0c5bed24
  > For full help, your family must make 250% or less of the Federal Poverty
- Discount level https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e9f313d3-75a8-4b35-a0c0-5a65c8fe3c6d
  > Patients whose family income is between 251 percent and 400 percent of the FPL may be eligible for discounted care
- Discount steps https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e9f313d3-75a8-4b35-a0c0-5a65c8fe3c6d
  > Uninsured and underinsured patients whose family income is 250 percent or less than the FPL are eligible for full or partial forgiveness
- Insured patients https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e9f313d3-75a8-4b35-a0c0-5a65c8fe3c6d
  > 3. Patients whose third-party coverage does not fully cover their medical expenses.
- Asset test https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e9f313d3-75a8-4b35-a0c0-5a65c8fe3c6d
  > Scripps limits its consideration of assets to health savings accounts held by the patient or the patient's family.
- Very large bills https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e9f313d3-75a8-4b35-a0c0-5a65c8fe3c6d
  > The patient's documented annual out-of-pocket medical expenses during the preceding 12 months exceed 10 percent of family income.
- What is not covered https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e9f313d3-75a8-4b35-a0c0-5a65c8fe3c6d
  > Physicians bill their services separately as independent contractors.
- Documents https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e9f313d3-75a8-4b35-a0c0-5a65c8fe3c6d
  > Only pay stubs and tax returns may be required as proof of income. Submission of other documentation is voluntary.
- Financial counseling phone https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=8acb6662-b5cb-426b-9ce6-cbae0c5bed24
  > CALL Scripps Financial Assistance Department at (858) 927-5902, Monday through Friday, 8:00 am to 5:00pm
- Facility named in policy https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e9f313d3-75a8-4b35-a0c0-5a65c8fe3c6d
  > which include Scripps Memorial Hospital La Jolla, Scripps Memorial Hospital Encinitas, Scripps Green Hospital, and Scripps Mercy Hospital

Last checked 2026-11-10.

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