HCAI Syfphr

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Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

ANTELOPE VALLEY HOSPITAL

1600 WEST AVENUE J
LANCASTER, CA 93534
https://www.avmc.org/

License:

General Acute Care Hospital
Total Beds: 420
Emergency Room: Yes
more... Link to Atlas

Contact:

Kayla Martz
(661) 949-5514

OSHPD ID:

106190034

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

6/1/2022

Download:

Federal Poverty Level for Free Care:

200%

Discount Payment Effective Date:

6/1/2022

Discount Payments

FPL Range: 201%-400%
Payment Basis:
Medicare
Medi-Cal

FPL Range: 0%-0%
Payment Basis:

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Application Form Information

Application Form Eff Date:

6/1/2022

Download:

Income Type Used:

Salary Received
Interest Received
Pension Received
Other: Alimony, Child Support, Real Estate, Social Secur

Language Information

Available Languages:

English
Spanish

Additional Information

Family Size	100%	150%	200%	250%	300%	350%	400%