# Glendora Hospital

Hospital in Glendora, CA. Verified from the hospital's own policy and the state program.

Glendora Hospital likely gives free care to households with a yearly income up to $31,920 for 1 person, $43,280 for 2, $54,640 for 3, $66,000 for 4, $77,360 for 5 or $88,720 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 | $31,920 | $63,840 |
| 2 | $43,280 | $86,560 |
| 3 | $54,640 | $109,280 |
| 4 | $66,000 | $132,000 |
| 5 | $77,360 | $154,720 |
| 6 | $88,720 | $177,440 |

Dollar amounts use the 2026 federal poverty guidelines.

## Discount steps

- 0% to 200% of poverty level, patient pays $0
- 201% to 400% of poverty level, patient pays no more than Medicare or Medi-Cal would pay, and no more than the amount generally billed (uninsured or high medical costs)
- 401% to null% of poverty level, patient pays 50% of billed charges (uninsured patients, no income test)

## How to apply

- Call (562) 256-8314 and ask for financial assistance.
- [Application form](https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=99076b30-ca04-4ef0-8b8a-0c6254b3fe72)
- [Financial Assistance Program Charity Care and Discount Care, Policy GD/BO-7001 (last revised 12/01/2024)](https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=492b1c42-5ad0-4f92-b424-47f563d8f0dd)
- 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 financial assistance application, income tax returns, or pay stubs if tax returns are not available, proof of essential living expenses if you need a payment plan.
- Very large bills. Insured patients with income up to 400% of the poverty level qualify for the discount if their yearly out-of-pocket costs top 10% of family 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. Emergency and medically necessary care at Glendora Hospital and its partial hospitalization programs, including copays, coinsurance, deductibles, and Medi-Cal share of cost.

Not covered. Physician services are not covered unless the doctor or group is on the policy's provider list. No provider list was attached to the filed 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 at or below 200% of the poverty level. From 201% to 400%, uninsured patients and patients with high medical costs pay no more than Medicare would. Every uninsured patient also gets 50% off billed charges with no income test, so no upper income limit is recorded for discounts. There is no time limit to apply. People with active Medi-Cal get unpaid hospital balances written off. Billing questions go to Patient Financial Services in Long Beach (1725 Pacific Ave, Long Beach, CA 90813), weekdays 7:30 am to 4:00 pm. Mail applications there, to the Business Office. If you are denied, you can ask the hospital to reconsider and send more papers. The policy says it was last revised 12/01/2024. The filed policy uses the name Glendora Hospital only and does not mention Glendora Community Hospital or Glendora Oaks Behavioral Health Hospital. It does not say whether assets are counted.

## Sources

- Free care level https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=492b1c42-5ad0-4f92-b424-47f563d8f0dd
  > Patients whose Patient Family Income is at or below 200% of the FPL are eligible to receive a 100% discount off their account balance
- Discount steps https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=492b1c42-5ad0-4f92-b424-47f563d8f0dd
  > Patients with High Medical Costs who do not qualify for Charity Care/Free Care and whose Patient Family Incomes are at or below 400% of FPL
- Discount steps https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=492b1c42-5ad0-4f92-b424-47f563d8f0dd
  > the patient liability will be no more than what Medicare would typically pay.
- Discount steps https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=492b1c42-5ad0-4f92-b424-47f563d8f0dd
  > will receive a 50% discount from billed charges without taking into consideration their ability to pay
- Insured patients https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=492b1c42-5ad0-4f92-b424-47f563d8f0dd
  > Financial Assistance may be applied to uninsured patients, as well as the patient liability for patients with insurance
- Very large bills https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=492b1c42-5ad0-4f92-b424-47f563d8f0dd
  > Annual out-of-pocket costs incurred by the individual at the hospital that exceed the lesser of 10 percent of the patient’s current family income
- What is not covered https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=492b1c42-5ad0-4f92-b424-47f563d8f0dd
  > Eligible Services exclude physician services, treatments, or procedures unless the Financial Assistance Policy’s provider list includes the relevant physician or physician group
- Deadline https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=492b1c42-5ad0-4f92-b424-47f563d8f0dd
  > Glendora Hospital shall not impose time limits for applying for Charity Care/Free Care or discounted payments
- Documents https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=492b1c42-5ad0-4f92-b424-47f563d8f0dd
  > documentation of income shall be limited to income tax returns, or if income
- Languages https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=492b1c42-5ad0-4f92-b424-47f563d8f0dd
  > the Hospital has policies available in English and Spanish.
- Financial counseling phone https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=492b1c42-5ad0-4f92-b424-47f563d8f0dd
  > please contact Patient Financial Services (billing department) at 562-256-8314.

Last checked 2026-11-10.

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