UCI Health - Fountain Valley
Acute care hospital in Fountain Valley, CA.
Verified from the hospital's own policy
UCI Health - Fountain Valley 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. We have not found a discount for incomes above the free care level.
The hospital makes the final decision.
| People in household | Free care up to | Discount up to |
|---|---|---|
| 1 | $63,840 | not found |
| 2 | $86,560 | not found |
| 3 | $109,280 | not found |
| 4 | $132,000 | not found |
| 5 | $154,720 | not found |
| 6 | $177,440 | not found |
Discount steps
- 0% to 400% of poverty level, you pay $0 (uninsured: all charges written off; insured with high medical costs: out-of-pocket amount written off)
- 401% to % of poverty level, you pay uninsured only: 70% off total hospital charges, and 50% off professional charges for facility-based providers
How to apply
- Call (833) 353-7700 and ask for financial assistance.
- Application form
- UCI Health System-Wide Charity Care Policy (PolicyStat ID 17692717, last revised 03/2025)
- Bring most recent filed federal tax return or at least six months of recent pay stubs, insured patients with high medical costs must show proof of payment of medical costs.
- 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.
- Very large bills
- Insured patients with family income at or below 400% of the poverty level whose out-of-pocket medical costs in the past 12 months, at UCI Health or anywhere else, are over 10% of family income.
- Languages
- English, Spanish, Vietnamese
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 care at UCI Health hospitals, including hospital-based professional fees and provider-based clinics.
- Not covered
- Services that are not medically necessary. Physician services billed separately, not by UCI Health.
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
This is the UC Irvine Health system-wide policy, and it lists UCI Health - Fountain Valley by name. Free care at or below 400% of the poverty level for uninsured patients. Insured patients at or below 400% with medical costs over 10% of family income can get their out-of-pocket amount written off. One section instead calls this a discount down to the highest government program rate, so ask which you will get. Uninsured patients above 400% get 70% off hospital charges under a separate Uninsured Discount Policy, with no top income limit. You may be asked to apply for Medi-Cal or other programs first. The policy is unclear on savings and property. One section says assets are not considered and another says eligibility includes monetary assets. California law since 2025 does not allow hospitals to count monetary assets. You can apply any time, even during collections. Outpatient approval lasts six months. The phone number is the UCI Health Single Billing Office for all its hospitals. UCI Health's financial assistance web page is https://www.ucihealth.org/patients-and-visitors/financial-resources/financial-assistance. The state also lists this hospital under its old name, Fountain Valley Regional Hospital and Medical Center. The policy on file is a scanned copy read by text recognition, and the application on file is a scan with no readable text.
Sources
- Free care level
financially eligible self-pay patient who received medically necessary care and the family income is at or below 400% of the Federal Poverty Level
- Discount steps
70% discount off total hospital charges
- Insured patients
High Medical Cost patients with third party coverage whose family incomes are at or below 400% of the FPL with high medical costs are eligible
- Very large bills
Out of pocket medical expenses in prior12 months (whether incurred at UCI Health or any other health care provider) exceeds 10% of family income
- What is not covered
This policy excludes services that are not medically necessary and separately billed physician professional services, not billed by UCI Health.
- Deadline
may apply for financial assistance any time after the first post-discharge billing statement or any time during the collection process.
- Documents
Patient's Family income is verified with the most recent filed Federal tax return or a minimum of six months recent paycheck stubs.
- Languages
Notices should be provided in English, Spanish, Vietnamese and any other languages as determined by UCI Health preferred language.
- Financial counseling phone
or by calling our Single Billing Office at 833-353-7700.
Last checked. 2026-11-10
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