Financial Assistance
Assistance with Your Bill
The Plain Language Summary for Financial Assistance is for any individual who received emergency medical services at St. Rose Hospital. St. Rose Hospital is committed to providing Financial Assistance for Services to patients who are low income, uninsured, underinsured, or ineligible for a government program. Elective services are not covered by the Financial Assistance policy.
Do I Qualify for Financial Assistance?
Financial Assistance refers to full charity or discounted care based on the Federal Poverty Guidelines, which includes income and number of persons per household.
Charity Care
Full charity care is available to patients who have no source of payment for any portion of their medical expenses including without limitation, commercial or other Insurance, government sponsored health care benefit programs or third party liability. Full charity will be offered if family incomes are at or below the 400% of the most recent Federal Poverty Income Guidelines.
Discounted Care
- Self-Pay Patients that do not qualify for Charity Care under St. Rose Hospital’s Charity Care Policy (Self-Pay Discounted Care); and
- Patients with High Medical Costs that do not qualify for Charity Care under St. Rose Hospital’s Charity Care Policy (High Medical Costs Discounted Care).
Applying for Financial Assistance
Applications must be completed and required documents submitted with the application.
- Financial Assistance / Charity Care Policy
- Financial Assistance Application English | Spanish
- Financial Assistance Charity Care Notification Letter
- Financial Assistance Charity Care Worksheet
- 2024 Federal Poverty Income Guidelines
- Uninsured/Underinsured Policy
- Financial Assistance: Plain Language Summary English | Spanish
We ask that you be considerate of the rights and privacy of other patients and respectful of the employees and property of St. Rose Hospital.
Our Patient Advocate can help determine your financial assistance eligibility. If applicable, they can help you apply for Medi-Cal, set up a payment plan, or help with the charity application process. The contact phone number for our Patient Advocate is (510) 780-4342. All financial assistance applications should be submitted with all required documents to:
Attn: Patient Advocate
St. Rose Hospital
27200 Calaroga Avenue
Hayward, CA 94545
Phone Number
(510) 264-4000