# California Pacific Medical Center- Van Ness Campus

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

California Pacific Medical Center- Van Ness Campus 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.

| Household size | Free care if yearly income is up to | Discount if yearly income is 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 |

Dollar amounts use the 2026 federal poverty guidelines.

## Discount steps

- 0% to 400% of poverty level, patient pays $0 (full write-off of all charges) for uninsured patients
- 0% to 400% of poverty level, patient pays $0 of the insured patient's share when out-of-pocket medical costs in the past 12 months exceed 10% of family income

## How to apply

- Call (415) 600-6000 and ask for financial assistance.
- [Application form](https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=fb5e6255-9bc5-4ef8-96a5-500d25d9d1c2)
- [Policy on Financial Assistance for Sutter Hospitals (Charity Care), effective January 1, 2026](https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e69c252a-04e7-4ce3-b713-105d50c0867e)
- 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 recent pay stubs, or recent tax returns.
- Savings and property. The policy looks at income only, not savings or property.
- Very large bills. Insured patients at or below 400% of the poverty level whose out-of-pocket medical costs in the past 12 months exceed 10% of family income
- Languages. English, Arabic, Armenian, Cambodian/Khmer, Chinese Traditional, Farsi, Hindi, Hmong, Japanese, Korean, Punjabi, Russian, Spanish, Tagalog, Thai, 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. All services the hospital is licensed to provide, including emergency and other medically necessary care. Hospital staff such as nurses, therapists, pharmacists, and technicians are covered.

Not covered. Doctors who bill separately are not covered. This includes emergency room doctors, anesthesiologists, radiologists, hospitalists, and pathologists. Elective services that insurance normally excludes, such as cosmetic procedures, are 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.

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 hospital is listed in the policy's Attachment I as California Pacific Medical Center, Van Ness Campus, 1101 Van Ness Avenue, San Francisco. One Sutter policy covers every Sutter hospital. If you have no insurance and your family income is at or below 400% of the poverty level, the hospital bill is free. If you have insurance, the part you owe is written off when family income is at or below 400% and your out-of-pocket medical costs in the past 12 months are more than 10% of family income. If your insurance benefits ran out before or during a hospital stay, you can also apply at or below 400%. The policy has no partial discounts between free and full price. Sutter does not look at savings or other assets. There is no deadline to apply. You can apply in person, by phone, by mail, or on sutterhealth.org. Mailed applications go to Sutter Health, P.O. Box 619010, Roseville, CA 95661-9998, attention Charity Care Application. Proof of income is recent pay stubs or tax returns. Approval lasts one year. If you are denied, you can dispute it with the hospital's chief financial officer within 30 days, by phone or in writing. Medi-Cal patients get denied or non-covered hospital charges written off as charity care. An uninsured patient who wants approval before a transplant or other complex or experimental service needs sign-off from the hospital's chief financial officer first. The phone number is the hospital's Patient Access/Registration desk, which the policy lists for help with financial assistance. Sutter's Patient Financial Services line is (855) 398-1633, 8 AM to 5 PM, Monday through Friday. The plain language summary is printed inside the policy as Attachment G. The language list is the policy's notice offering help by phone in each language.

## Sources

- Free care level https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e69c252a-04e7-4ce3-b713-105d50c0867e
  > for any portion of their medical expenses and have a family income at or below 400% of the federal poverty level.
- Free care level https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e69c252a-04e7-4ce3-b713-105d50c0867e
  > Charity Care means full financial assistance that is in the form of free care (i.e., 100% discount) to qualifying patients
- Discount level https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e69c252a-04e7-4ce3-b713-105d50c0867e
  > Patients who are covered by insurance but have (i) family income at or below 400% of the federal poverty level
- Discount steps https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e69c252a-04e7-4ce3-b713-105d50c0867e
  > Patients who have no third-party source of payment, such as an insurance company or government program, for any portion of their medical expenses
- Insured patients https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e69c252a-04e7-4ce3-b713-105d50c0867e
  > Patients who are covered by insurance but have (i) family income at or below 400% of the federal poverty level
- Asset test https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e69c252a-04e7-4ce3-b713-105d50c0867e
  > Hospitals shall not consider Patients’ monetary assets when determining eligibility for Financial Assistance.
- Very large bills https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e69c252a-04e7-4ce3-b713-105d50c0867e
  > (incurred at the hospital affiliate or paid to other providers in the past 12 months) that exceed 10% of the patient’s family income.
- What is not covered https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e69c252a-04e7-4ce3-b713-105d50c0867e
  > Services of physicians such as anesthesiologists, radiologists, hospitalists, pathologists, etc. are not covered under this policy.
- Documents https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e69c252a-04e7-4ce3-b713-105d50c0867e
  > A Patient shall only be required to provide recent pay stubs or tax returns as proof of income
- Languages https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e69c252a-04e7-4ce3-b713-105d50c0867e
  > Mult-language Interpreter Services ATTENTION: If you need help in your language, please call 855-398-1633
- Financial counseling phone https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e69c252a-04e7-4ce3-b713-105d50c0867e
  > Van Ness Campus 1101 Van Ness Avenue San Francisco, CA 94109 415-600-6000
- Facility list https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e69c252a-04e7-4ce3-b713-105d50c0867e
  > California Pacific Medical Center Patient Access/Registration
- Deadline https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=e69c252a-04e7-4ce3-b713-105d50c0867e
  > Hospitals will not impose time limits for applying for financial assistance under this policy

Last checked 2026-11-10.

HTML page https://hospitalaid.org/hospitals/california-pacific-medical-center-van-ness-campus-san-francisco-ca/
Report an error corrections@hospitalaid.org