Patient financial assistance program for physician services

UCLA Health physicians strive to provide quality patient care and meet high standards for the communities we serve. We are committed to helping eligible patients who are not able to pay for all or part of their care. Our mission and vision include providing full financial assistance (100% discount) or partial discounts to eligible patients who are low income, uninsured or under-insured. Further information on UCLA Health Physicians' Financial Assistance Program is provided below.

Eligible services

The Financial Assistance Program applies to emergency or other medically necessary healthcare services provided and billed by UCLA Health physicians.

Determination of eligibility

Eligibility is determined based on review of a fully completed Financial Assistance Application and supporting documents, including proof of income, assets and liabilities. Generally, patients with family income at or below 200% of the Federal Poverty Level will be eligible for a discount of up to 100%. Patients with family income between 201% and 350% of the Federal Poverty Level may be eligible for a partial discount based on income level.

If you receive financial assistance under our policy, you will not be charged more for emergency or other medically necessary care than the amount generally billed to patients having Medicare fee-for-service coverage. In some instances, patients may be presumptively determined eligible for financial assistance.

To view U.S. federal poverty guidelines used to determine financial eligibility, visit:

How to obtain copies of our financial assistance policy and application

  • On this page of the UCLA Health website (see links below).
  • To request documents by mail, contact our Physicians' Billing Office Customer Service at 310-301-8860 (Monday through Friday, 7:00 am to 7:00 pm).

How to obtain assistance with our financial assistance program?

Contact our Physicians’ Billing Office Customer Service at 310-301-8860 (Monday through Friday, 7:00 am to 7:00 pm).


The Financial Assistance Policy, Financial Assistance Application, and Plain Language Summary are available in English, Spanish, Farsi, Arabic and Chinese in the “Documents” section below on this page, or separately in paper upon request.

If you would like an interpreter to help you with a different language, please contact our Interpreter Services Program at 310-267-8001. The UCLA Health Interpreter/Translation Services Program provides services to all UCLA Health patients and their relatives at no cost. For more information regarding UCLA Health’s Interpreter/Translation Services Program, visit:

How to apply for our financial assistance program

The Financial Assistance Application with all supporting documents may be mailed to:

Mail to:

UCLA Health - Physicians' Billing Office
Financial Assistance Program
5767 West Century Blvd., Suite 400
Los Angeles, CA 90045

Financial assistance program Documents

Financial Assistance Application

Plain Language Summary

Financial Assistance Policy