# Lompoc Valley Medical Center

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

Lompoc Valley Medical Center 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 (full charity care) for uninsured patients and patients with high medical costs
- 201% to 400% of poverty level, patient pays What Medicare would pay. If insured, the gap between what insurance paid and the Medicare amount, or nothing if insurance paid more.

## How to apply

- Call (805) 737-3300 and ask for financial assistance.
- [Application form](https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=536ba54e-f39e-4a79-9618-49b44a420c47)
- [Bad Debt, Charity Care/Discount Payment Policy (issued 12/29/21; on file with HCAI, effective 12/29/2021)](https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=a0883eed-967c-4407-b304-5fc6561c061d)
- The policy gives 365 days to apply. Ask the billing office which date the count starts from.
- Bring recent federal income tax return, recent W-2, 2 recent pay stubs, proof of public assistance such as disability, unemployment, or Social Security.
- Savings and property. The policy counts savings or property, not only income.
- Very large bills. Uninsured patients above 400% of the poverty level with a catastrophic medical event may be considered case by case, generally for a patient balance over $45,000; income and assets are weighed

## 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 inpatient, outpatient, recurring, and emergency hospital services provided by Lompoc Valley Medical Center

Not covered. Doctors' services at the hospital are not covered. Emergency doctors must keep their own discount policy. Services mainly for comfort or convenience are not covered. Care is not covered if you asked the hospital not to bill your insurance, or if insurance denied it because you did not give the insurer information.

## 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 policy was issued in December 2021 and is still the one on file with the state. Free care at or below 200% of the poverty level for uninsured patients and patients with high medical costs. From 201% to 400% you pay no more than Medicare would pay. If you have insurance, you owe only the gap between what insurance paid and the Medicare amount. The policy limits applications to 12 months after the date of service and says it reviews the assets of Medicare patients. California rules now bar hospitals from setting application deadlines or counting most assets, so ask the hospital about this. Medi-Cal share of cost is not waived. People who are homeless or eligible for Medi-Cal or other low-income programs may get free care. Payment plans are interest free. Appeals go in writing to the Director of Business Operations, then the CFO. The policy and application do not print a phone number or mailing address.

## Sources

- Free care level https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=a0883eed-967c-4407-b304-5fc6561c061d
  > If an uninsured or High Medical Costs patient's family income is 200% or less of the established poverty income level
- Discount level https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=a0883eed-967c-4407-b304-5fc6561c061d
  > Patients between 201% and 400% of FPL or Patient with High Medical Costs will not pay more than Medicare would typically pay
- Discount steps https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=a0883eed-967c-4407-b304-5fc6561c061d
  > the patient's payment obligation will be the gross amount the Medicare program would have paid for the service if the patient were a Medicare beneficiary.
- Insured patients https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=a0883eed-967c-4407-b304-5fc6561c061d
  > Underinsured patients or Patient with High Medical Costs whose income is below 400% of the federal poverty level and who personally owe an amount
- Asset test https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=a0883eed-967c-4407-b304-5fc6561c061d
  > Any evaluation for financial assistance relating to patients covered by the Medicare Program must include a reasonable analysis of all patient assets
- Very large bills https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=a0883eed-967c-4407-b304-5fc6561c061d
  > any account with a patient liability for services rendered that exceeds $45,000 may be considered for eligibility as a catastrophic medical event.
- What is not covered https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=a0883eed-967c-4407-b304-5fc6561c061d
  > This policy does not apply to physician services rendered at LVMC.
- Deadline https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=a0883eed-967c-4407-b304-5fc6561c061d
  > Financial assistance will be considered up to twelve (12) months from the date of service.
- Documents https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=536ba54e-f39e-4a79-9618-49b44a420c47
  > Copy of recent Federal income tax return. 2. Copy of recent W-2 3. Copy of 2 recent pay stubs

Last checked 2026-11-10.

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