Help Paying Your Bill

Health coverage can be complicated. That’s why we offer free help applying for health coverage and financial assistance programs. We’ll tell you which programs you’re eligible for, explain how they work, and then help you apply. Help is available by phone or in person at locations across the county. Call us at 650-616-2002 to start your application.

We also offer prompt-pay discounts and payment plans. If you need help paying your bill we offer discounted payments and charity care. We help you get coverage or financial assistance so you and your care team can focus on your health.

Insurance & Coverage Programs We Accept

San Mateo Medical Center’s hospital and clinics currently accept the following insurance/coverage plans:

• Medi-Cal (Medicaid)
• MediCare
• ACE
• Health Plan of San Mateo (Medi-Cal, Care Advantage and HealthWorx)

Financial Assistance Programs & Eligibility

We offer programs to help with charges from our hospital and clinics. These are not insurance programs.

Discounted Health Care Program

This program offers a discount to patients who:

1. Have a current household income at, or below, 400% of the Federal Poverty Level AND
2. Are uninsured OR have insurance but also have high medical costs.

High medical costs are defined as annual out-of-pocket expenses for medical care that are more than 10% of the patient’s current family income OR income in the prior 12 months (whichever is lower). Insured patients applying for this program must submit proof of their out-of-pocket expenses.

All applicants must submit proof of income and identity.

Financial Hardship Assistance

Financial Hardship Assistance is for patients who have a financial hardship and cannot pay for the services received at our hospital or clinics. If approved, patients get a discount of 100% and will not be responsible for the balance due.
Financial hardship includes, but is not limited to:

• Death of family member (living in household or claimed on taxes) within last 6 months
• Loss of job or reduction of income
• Illnesses or accidents
• Loss of Housing (foreclosure, eviction, natural disaster, etc.)
• Financial Liability (bankruptcy, lien, lawsuits, etc.)

Patients applying for this program must submit proof of income, identity, household assets and financial hardship.

Charity Care Program

Patients are eligible for the Charity Care Program if their current household income is at, or below, 138% of the Federal Poverty Level. Patients applying for this program must submit proof of income and identity.

Financial Assistance Policy

Transparency is important when making financial decisions so we are happy to share our financial assistance policy. If you have questions, we are happy to talk with you about our policy at any time. Just call 650-573-2525.

The policy covers

• Available financial assistance programs, how to qualify, and how we can help if you don’t qualify.
• How to apply, including what kinds of documents are needed and what kind of income is counted.
• How to appeal decisions related to your eligibility.
• Cost-sharing information for different services.
• Our billing and collection practices.
• How we handle fraud.

Top 4 things you must do:

• Apply for financial assistance as soon as possible. You can apply for some programs after your visit, but the earlier you apply, the better.
• Provide all the personal and financial information requested by the deadline we give you.
• Tell us when things change (address, job, income, family size, etc.)
• Renew your coverage every year.

Good Faith Estimate

Under the law, health care providers need to give patients who don’t have insurance, or who are not using insurance, an estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least one (1) business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, call 650-573-2525.

Get an Estimate Now

Patients can use our self-service estimate tool to get an estimate of costs in the resource library below.

The estimate will be based on the health insurance plan and the procedure(s) you select. The estimate will clearly show the estimated price of the procedure(s), your health coverage benefits, including deductible, co-insurance, and co-pay, plus your estimated out-of-pocket responsibility amount.

Disclaimer: Information provided is only an estimate and is not a guarantee of final billed charges. Final billed charges may vary from estimates for many reasons including the patient’s medical condition, unknown circumstances or complications, final diagnosis, and recommended treatment ordered by the provider. Insurance benefit information (where applicable) is based on information provided by your insurance company as of the date of this estimate. Benefits and eligibility are subject to change and are not a guarantee of payment. If you need help, please call 650-573-2525.

Price Transparency

In the resource library below, SMMC publishes a list of all the hospital procedures (shopable services) we offer and the costs (Charge Description Master). Please note this data does not reflect out-of-pocket costs for insured patients. The data also does not reflect all of the discounts for which uninsured patients may be eligible.

No Surprise Billing

Surprise billing happens when a patient gets care from a provider who is not in their health plan’s network. We are not a network provider for any commercial insurance health plans. If you are seeking non-emergency care at San Mateo Medical Center, you will be asked to sign the consent form below to waive federal protections and pay more for out-of-network care. You can choose to get non-emergency care from a provider or facility in your health plan’s network, which may cost you less.

Open Payments Database

The federal Physician Payments Sunshine Act requires detailed information about payment and gifts of value worth more than ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public. You can search a federal database for payments made to physicians and teaching hospitals by visiting this website: https://openpaymentsdata.cms.gov.

San Mateo County Health has policies that strictly govern how our organization interacts with drug manufacturers and others we do business with, including prohibiting gifts of any value.

Hospital Bill Complaint Program

The Hospital Bill Complaint Program is a state program that reviews hospital decisions about whether you qualify for help paying your hospital bill. If you believe you were wrongly denied financial assistance, you may file a complaint with the Hospital Bill Complaint Program. Visit the resource library below for more information and to file a complaint.

340B Program

San Mateo Medical Center is eligible to participate in the 340B program because we provide care to a disproportionate share of low-income Medicare and Medi-Cal (Medicaid) patients.

Benefits of the 340B Program
San Mateo Medical Center realized $12 million in savings through participation in the 340B program, which supports our ability to provide services to under- and uninsured patients, regardless of their ability to pay, and to address health care needs in our community. In addition to providing free and discounted prescription drugs to low-income patients, San Mateo Medical Center provides a variety of services to help care for the most vulnerable in our community, including: