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Hospital Details

Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

HUNTINGTON MEMORIAL HOSPITAL

100 W. CALIFORNIA BOULEVARD
PASADENA, CA 91105
http://www.huntingtonhospital.com

License:

General Acute Care Hospital
Total Beds: 619
Emergency Room: Yes
more... Link to Atlas

Contact:

Patient Accounting Department
(626) 397-5000

OSHPD ID:

106190400

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

1/1/2019

Download:

Policy File

Federal Poverty Level for Free Care:

200%

Discount Payment Effective Date:

1/1/2019

Discount Payments

Discount Payment 1

FPL Range: 200%-400%
Payment Basis:
Other: AGB

Discount Payment 2

FPL Range: 0%-0%
Payment Basis:

Discount Payment 3

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Annual Income is FAP Eligibility % Below 200% of FPL 100% or FREE 201% to less than 250% of FPL 75% 251% to less than 350% of FPL 50% 351% to 400% 25% Greater than 400% 0%

Application Form Information

Application Form Eff Date:

1/1/2019

Download:

Application File

Income Type Used:

Salary Received
Interest Received
Pension Received
Other: Tax Return, Proof of public aid

Language Information

Available Languages:

English
Spanish
Vietnamese
Tagalog
Korean
Chinese
Armenian
Russian

Additional Information

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