Financial Assistance

St. Rose Hospital > Financial Assistance

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 patients who are low income, uninsured, underinsured, or ineligible for a government program.

Do I Qualify for Financial Assistance?

Financial Assistance refers to Charity Care or Discounted Care based on the Federal Poverty Guidelines which includes income and number of persons per household.

            ○ 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 healthcare benefit programs or third-party liability. Charity Care will be offered if family income is at or below the 400% of the most recent Federal Poverty Income Guidelines.

            ○ Charity Care is also available to patients with High Medical Costs and whose family income is at or below 400% of the most recent Federal Poverty Income Guidelines.

            ○ Discounted 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 healthcare benefit programs or third-party and are between 400% and 500% of the most recent Federal Poverty Income Guidelines.

            ○ Discounted Care is also available to patients with High Medical Costs and are between 400% and 500% of the most recent Federal Poverty Income Guidelines.

Applying for Financial Assistance

To begin the financial assistance process, please contact our Patient Financial Advocate:

Phone: 510-780-4342

To apply for financial assistance: you will complete a written application and provide supporting documentation. The following documents would be required as proof of income.

            ○ Last 2 months of paycheck stubs or unemployment records

            ○ Last year’s income tax return or non-filing letter

            ○ Housing Verification letter

All Financial assistance applications should be submitted with all required documents to:

St. Rose Hospital

Attn: Patient Financial Advocate

27200 Calaroga Ave

Hayward, CA  94545 

Here are links to:

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 also  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