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Hospital Details
Policy Effective Date (Date Posted):
2022-2023 (Most Recent)
2022-2023 (11/15/2022)
2014-2015 (5/5/2015)
2012-2013 (6/1/2012)
2012-2013 (6/1/2012)
2010-2011 (12/10/2009)
2008-2009 (6/12/2008)
2008-2009 (6/12/2008)
Go
Download:
Policy File
Download:
Application File
General Information
Hospital:
WEST COVINA MEDICAL CENTER
725 SOUTH ORANGE AVENUE
WEST COVINA, CA 91790
https://westcovinamc.com
License:
General Acute Care Hospital
Total Beds:
46
Emergency Room:
Yes
more...
Contact:
Gerald Wallman
(626) 338-8481
OSHPD ID:
106190857
Fair Pricing Policy Information
Show FPL Chart
Policy Effective Date:
1/1/2015
Download:
Policy File
Federal Poverty Level for Free Care:
0%
Discount Payment Effective Date:
1/1/2015
Discount Payments
Discount Payment
1
FPL Range:
0
%-
350
%
Payment Basis:
Medicare
Discount Payment
2
FPL Range:
0
%-
0
%
Payment Basis:
Discount Payment
3
FPL Range:
0
%-
0
%
Payment Basis:
Other Discount Payment Information:
Application Form Information
Application Form Eff Date:
1/1/2015
Download:
Application File
Income Type Used:
Language Information
Available Languages:
English
Spanish
Additional Information
All cash patients are offer the medicare rate or less.
Family
Size
100%
150%
200%
250%
300%
350%
400%
