# Banner Lassen Medical Center

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

Banner Lassen Medical Center likely gives free care to households with a yearly income up to $31,760 for 1 person, $43,064 for 2, $54,367 for 3, $65,670 for 4, $76,973 for 5 or $88,276 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 | $31,760 | $63,840 |
| 2 | $43,064 | $86,560 |
| 3 | $54,367 | $109,280 |
| 4 | $65,670 | $132,000 |
| 5 | $76,973 | $154,720 |
| 6 | $88,276 | $177,440 |

Dollar amounts use the 2026 federal poverty guidelines.

## Discount steps

- 0% to 199% of poverty level, patient pays $0 (100% discount off the AGB if uninsured, or off what you owe after insurance)
- 200% to 300% of poverty level, patient pays 25% of the AGB (75% discount), or 25% of what you owe after insurance
- 301% to 400% of poverty level, patient pays 50% of the AGB (50% discount), or 50% of what you owe after insurance

## How to apply

- Call (888) 264-2127 and ask for financial assistance.
- [Application form](https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=835f5892-ab14-410c-b8c3-c65ef90b9717)
- [Banner Lassen Medical Center Financial Assistance Policy for Hospital Patients (No. 3658, version 6, effective 12/17/2025)](https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=03ec133e-0d85-4483-a431-91351023cbe5)
- 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 income tax returns for the year first billed or the 12 months before, or the 3 most recent pay stubs from within 6 months before or after the first bill.
- Very large bills. Medically indigent households, where the family's share of medical bills in the past 12 months is over 50% of household income, get 75% off the remaining balance at any income
- Languages. English, Spanish

## 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 hospital services at Banner Lassen Medical Center, plus Banner Medical Group hospitalists, intensivists, specialists, and telemedicine providers.

Not covered. Hospitalists, intensivists, specialists, anesthesiologists, and telemedicine providers not employed by Banner are not covered, unless Banner does their billing. Banner urgent care, imaging, and clinics fall under a separate policy.

## 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

Free care if household income is below 200% of the poverty level. From 200% to 300% you get 75% off, and above 300% to 400% you get 50% off. For uninsured patients the discount comes off the amount generally billed. For insured patients it comes off what you owe after insurance. Your bill can never be more than Medicare or Medi-Cal would pay, or the amount generally billed, whichever is less. Uninsured patients above 400% start at 125% of the amount generally billed. If you enroll in Medi-Cal within 12 months after care, the bill is written off. Appeals go to a Patient Financial Services business manager. The policy gives no deadline to apply and does not say whether savings are counted. The phone number is Banner Health's system-wide Patient Financial Services line. No local Banner Lassen number is printed.

## Sources

- Free care level https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=03ec133e-0d85-4483-a431-91351023cbe5
  > < 200% of FPL 100% discount off AGB 100% discount off BAI
- Discount level https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=03ec133e-0d85-4483-a431-91351023cbe5
  > > 300% - 400% FPL 50% discount off AGB 50% discount off BAI
- Discount steps https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=03ec133e-0d85-4483-a431-91351023cbe5
  > 200% - 300% FPL 75% discount off AGB 75% discount off BAI
- Insured patients https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=03ec133e-0d85-4483-a431-91351023cbe5
  > Uninsured Patients and Underinsured Patients will qualify for financial assistance based on household income
- Very large bills https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=03ec133e-0d85-4483-a431-91351023cbe5
  > where the portion for which the household is responsible exceeds 50% of the household's total income for that year.
- What is not covered https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=03ec133e-0d85-4483-a431-91351023cbe5
  > Non-Banner Employed1 – Anesthesiologists
- Documents https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=03ec133e-0d85-4483-a431-91351023cbe5
  > 3 most recent pay stubs, if they occurred within a 6-month period before or after the patient was first billed by the Hospital.
- Languages https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=835f5892-ab14-410c-b8c3-c65ef90b9717
  > Spanish translations of
- Financial counseling phone https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=835f5892-ab14-410c-b8c3-c65ef90b9717
  > available by mail by contacting Banner Patient Financial Services at (888) 264-2127.

Last checked 2026-11-10.

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