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Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

L.A. DOWNTOWN MEDICAL CENTER - INGLESIDE CAMPUS D/P APH

7500 HELLMAN AVENUE
ROSEMEAD, CA 91770
http://cofamc.org

License:

General Acute Care Hospital
Total Beds: 118
Emergency Room: Yes
more... Link to Atlas

Contact:

John Cowles
(213) 989-6100

OSHPD ID:

106190410

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

12/28/2007

Download:

Federal Poverty Level for Free Care:

350%

Discount Payment Effective Date:

12/28/2007

Discount Payments

FPL Range: 351%-400%
Payment Basis:
Other: 75% Discount

FPL Range: 401%-450%
Payment Basis:
Other: 50% Discount

FPL Range: 451%-500%
Payment Basis:
Other: 25% Discount

Other Discount Payment Information:

Application Form Information

Application Form Eff Date:

12/28/2007

Download:

Income Type Used:

Salary Received
Interest Received
Pension Received

Language Information

Available Languages:

English
Spanish

Additional Information

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