# NorthBay Medical Center

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

NorthBay Medical Center likely gives free care to households with a yearly income up to $22,025 for 1 person, $29,863 for 2, $37,702 for 3, $45,540 for 4, $53,378 for 5 or $61,217 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 | $22,025 | $63,840 |
| 2 | $29,863 | $86,560 |
| 3 | $37,702 | $109,280 |
| 4 | $45,540 | $132,000 |
| 5 | $53,378 | $154,720 |
| 6 | $61,217 | $177,440 |

Dollar amounts use the 2026 federal poverty guidelines.

## Discount steps

- 0% to 138% of poverty level, patient pays $0
- 139% to 400% of poverty level, patient pays 100% of the Medicare fee schedule, with reasonable payment terms

## How to apply

- Call (707) 646-5637 and ask for financial assistance.
- [Application form](https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=391ce0ae-a68e-4463-9aec-7fa6a7064f5e)
- [Financial Assistance Program (last approved 01/2025)](https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=324e3d0b-e159-40cd-ac38-11218de6e854)
- 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 proof of identity and residency (a signed statement is accepted if you are homeless or because of immigration status), recent pay stubs or income tax returns (a signed statement is accepted in the same cases).
- Savings and property. The policy looks at income only, not savings or property.
- Very large bills. For families at or below 400% of the poverty level, yearly hospital bills are capped at 10% of family income from the last year.
- 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 inpatient, outpatient, and emergency care billed by NorthBay Health. Services an insurer denies or does not cover can also count.

Not covered. Doctors' fees not billed by NorthBay are not covered. Emergency doctors must give their own discount up to 400% of the poverty level.

## 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 138% of the poverty level. From 139% to 400%, you pay what Medicare would pay, with a payment plan of no more than 10% of monthly income after living costs. Above 400%, the policy points to separate discount plan guidelines for self-pay patients, which are not in the filed document. Insured patients with high medical costs can get help, and yearly bills are capped at 10% of income for families at or below 400%. Savings are not counted. You do not have to apply for public coverage, but you must take part in screening for it. The policy asks for proof of residency but does not say what residency is required. The application form lets NorthBay check your employment and credit. There is no deadline to apply. A decision comes within 30 days of a complete application. Appeals go in writing to the Director of Patient Access. The policy also names NorthBay VacaValley Hospital as a place to get the application.

## Sources

- Free care level https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=324e3d0b-e159-40cd-ac38-11218de6e854
  > If family income is 138% of the FPL or less: Charity Care with free care to the patient.
- Discount level https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=324e3d0b-e159-40cd-ac38-11218de6e854
  > If family income is 139% to 400% of the FPL: Reduced Care to the patient at 100% of the Medicare Fee Schedule
- Discount steps https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=324e3d0b-e159-40cd-ac38-11218de6e854
  > If family income is above 400% of the FPL: Refer to Discount Plan Guidelines for Self-Pay and Self-Pay After Insurance.
- Insured patients https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=324e3d0b-e159-40cd-ac38-11218de6e854
  > or have insurance with high medical costs or out-of-pocket expenses not reimbursement by insurance or a health coverage program.
- Asset test https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=324e3d0b-e159-40cd-ac38-11218de6e854
  > Monetary assets cannot be considered when determining a patient's eligibility.
- Very large bills https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=324e3d0b-e159-40cd-ac38-11218de6e854
  > NorthBay Health will limit annual family obligations for patients who family income does not exceed 400% of the FPL
- What is covered https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=324e3d0b-e159-40cd-ac38-11218de6e854
  > Medically necessary care is defined as any necessary inpatient, outpatient, or emergency medical care
- What is not covered https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=324e3d0b-e159-40cd-ac38-11218de6e854
  > Professional fees that are not billed by NorthBay Healthcare will not be covered under this Financial Assistance Policy.
- Application deadline days none https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=324e3d0b-e159-40cd-ac38-11218de6e854
  > There are no time limits on applying for financial assistance and eligibility determination shall be done at any time.
- Documents https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=324e3d0b-e159-40cd-ac38-11218de6e854
  > provide verification of income including recent pay stubs or income tax returns
- Languages https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=324e3d0b-e159-40cd-ac38-11218de6e854
  > Notices shall be posted in English and Spanish.
- Financial counseling phone https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=324e3d0b-e159-40cd-ac38-11218de6e854
  > may call the Financial Assistance Line at (707) 646-5637.
- Facility named in policy https://api.hdc.hcai.ca.gov/Public/Extract/Attachment?id=324e3d0b-e159-40cd-ac38-11218de6e854
  > NorthBay Medical Center (1200 B. Gale Wilson Blvd., Fairfield)

Last checked 2026-11-10.

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