Providence Mission Hospital
Nonprofit acute care hospital in Mission Viejo, CA.
Verified from the hospital's own policy
Providence Mission Hospital likely gives free care to households with a yearly income up to $47,880 for 1 person, $64,920 for 2, $81,960 for 3, $99,000 for 4, $116,040 for 5 or $133,080 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.
| People in household | Free care up to | Discount up to |
|---|---|---|
| 1 | $47,880 | $63,840 |
| 2 | $64,920 | $86,560 |
| 3 | $81,960 | $109,280 |
| 4 | $99,000 | $132,000 |
| 5 | $116,040 | $154,720 |
| 6 | $133,080 | $177,440 |
Discount steps
- 0% to 300% of poverty level, you pay $0 (100% write-off of patient responsibility)
- 301% to 400% of poverty level, you pay 83% off original charges, and never more than the amount generally billed (AGB)
How to apply
- Call (855) 229-6466 and ask for financial assistance.
- Application form
- Providence Financial Assistance (Charity Care/Discount Payment) Policy – California (Policy PSJH RCM 002 CA, dated 1/1/2025, implemented 1/27/2025)
- Bring proof of income, limited to recent pay stubs or income tax returns (a signed statement if you have none), bank account balances, only for Medicare patients who do not also have Medi-Cal.
- The policy gives 240 days to apply. Ask the billing office which date the count starts from.
- Savings and property
- The policy counts savings or property, not only income.
- Very large bills
- Income at or below 400% of the poverty level and total medical bills at Providence hospitals in the past 12 months over 20% of family income. This gets a one-time full write-off of what you owe on the date you apply.
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, urgent and other medically necessary services at Providence hospitals in California, including their inpatient and outpatient departments and clinics.
- Not covered
- Some physicians and medical groups who work in the hospital are not covered and bill separately. Each hospital keeps a list, online and on request. Emergency room physicians must give their own discounts up to 400% of the poverty level. Experimental, investigative, cosmetic and convenience care is 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.
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
Program source, 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.
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.
Program source, 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.
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
Program source, checked 2026-11-10
Notes
Free care at or below 300% of the poverty level, for insured and uninsured patients. Between 301% and 400%, you get 83% off the charges you owe, and you never pay more than the amount generally billed to insured patients. If your income is at or below 400% and your bills at Providence hospitals in the past 12 months were more than 20% of your family income, you can get a one-time write-off of everything you owe. Help can cover deductibles, copays and coinsurance. The policy still asks Medicare patients who do not also have Medi-Cal about assets. For them, the first $100,000 in savings, your home, retirement accounts, and one car do not count. Nobody else is asked about assets. The policy gives 240 days from the first bill after you leave the hospital, and it also says Providence can accept an application at any time. You get an answer within 30 days. You can appeal within 30 days of a denial. The phone number is the Providence customer service line for all its hospitals, Monday to Friday, 8 a.m. to 5 p.m. Providence also lists 503-215-7575. You can turn in an application at the hospital's financial counselor office. Language help is available, and translated forms are available on request. Exhibit A of the policy names this hospital in its Southern California list. The PDF filed with the state also has an older Providence bad-debt policy attached at the end.
Sources
- Free care level
Annual family income, adjusted for family size, is at or below 300% of the current FPL guidelines,
- Discount level
301% and 400% of the
- Discount steps
The patient is eligible for a Discounted Payment of 83%
- Insured patients
Financial assistance is available to both uninsured and insured patients if they meet the requirements of this policy.
- Asset test
For individuals who are not Medicare beneficiaries, or for individuals who have both Medicare and Medicaid insurance, no asset information will be requested or evaluated.
- Very large bills
has incurred total medical expenses at Providence hospitals in the prior 12 months in excess of 20% of their annual family income
- What is not covered
Each Providence hospital has a list of those physicians, medical groups, or other healthcare providers who are and who are not covered by this policy.
- Deadline
The FAP-Eligible Time Period for (i) hospital services is the 240-day period of time
- Documents
Documentation of income will be limited to recent pay stubs or income tax returns.
- Financial counseling phone
Customer Service Representatives at: 503-215-7575 or (+1) 855-229-6466
- Facility named in policy
Providence Mission Hospital Mission Viejo
Last checked. 2026-11-10
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