Santa Clara Valley Healthcare Financial Assistance: Free Care to 400% FPL + Discounts to 650% FPL (2026 Guide)
Santa Clara Valley Healthcare (SCVH) is a county-owned public hospital system in San Jose, California, and the second-largest public health system in the state. Through the Healthcare Access Program (HAP), SCVH offers 100% free care for patients with household income at or below 400% of the Federal Poverty Level (FPL), and sliding-scale discounts for patients earning up to 650% FPL. No citizenship requirement. The system serves all patients regardless of immigration status, insurance, or ability to pay.
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Quick Facts
100% Free Care (0-400% FPL)
Through the Healthcare Access Program (HAP), patients with household income at or below 400% FPL (~$63,840/yr single) receive completely free care
Sliding-Scale Discounts (401-650% FPL)
One of the highest thresholds in the country. A family of 4 earning up to ~$214,500 can still qualify for discounted care.
No Citizenship Requirement
As a county-owned public system, SCVH serves all patients regardless of immigration status. The county also helps patients apply for Medi-Cal.
240-Day Application Window
From your date of service. California AB 1020 prohibits extraordinary collection actions against eligible patients.
Insured Patients Qualify Too
If your out-of-pocket costs at SCVH exceed 10% of your family income, you qualify for financial assistance even if you have insurance. This is especially helpful for patients with high-deductible health plans.
Eligibility & Income Limits (2026 Federal Poverty Guidelines)
| Income Level (% FPL) | Approx. Income (Single) | Approx. Income (Family of 4) | Discount Level |
|---|---|---|---|
| 0-400% FPL | Up to ~$63,840/yr | Up to ~$132,000/yr | 100% Free Care (HAP) |
| 401-500% FPL | ~$63,841 - ~$79,800/yr | ~$132,001 - ~$165,000/yr | Sliding-scale discount |
| 501-650% FPL | ~$79,801 - ~$103,740/yr | ~$165,001 - ~$214,500/yr | Sliding-scale discount |
| Above 650% FPL | Above ~$103,740/yr | Above ~$214,500/yr | Not eligible (payment plans available) |
Important Notes
- At 650% FPL, a family of 4 earning up to ~$214,500 can still get discounted care. This is almost certainly the most generous threshold of any hospital system in the country.
- Both insured and uninsured patients are eligible. Insured patients qualify if out-of-pocket costs exceed 10% of family income.
- No citizenship requirement. SCVH is a county-owned system that serves all patients regardless of immigration status.
- Santa Clara County residency is preferred but not strictly required for emergency services.
- The Healthcare Access Program (HAP) is separate from and more generous than California's AB 1020 charity care law.
- Apply within 240 days of your date of service.
- The county also helps patients apply for Medi-Cal (California Medicaid), which now covers undocumented adults statewide.
2024 Refund Alert
In 2024, Santa Clara Valley Healthcare notified 43,000 former patients that they may have been eligible for charity care or discounts they never received. Many are owed refunds. If you received care at any SCVH facility in recent years and paid out of pocket, call (866) 967-4677 to check if you are owed money back.
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Get Help with Your BillCovered Facilities (3 Hospitals + County Clinics)
Hospitals
Main campus, San Jose. Level 1 Trauma Center.
San Jose
Gilroy
Clinics
Network of primary care and specialty clinics throughout Santa Clara County. The Healthcare Access Program (HAP) covers services at all SCVH-operated facilities.
The financial assistance policy applies to all Santa Clara Valley Healthcare facilities. As a county-owned system, SCVH cannot turn anyone away regardless of immigration status, insurance, or ability to pay.
Documents You Will Need
Proof of Identity (one of the following)
- Driver's license
- Passport
- Government-issued ID
- Work or school ID
- Birth certificate + another form of ID (gym card, Costco card, etc.)
Proof of Income (one of the following)
- Recent pay stubs
- Tax returns
That's it. SCVH deliberately keeps documentation requirements minimal to reduce barriers to care. Unlike private hospital systems that demand bank statements, asset verification, and extensive paperwork, the county system only needs basic ID and income proof.
How to Apply (Step by Step)
Check Your Eligibility
100% free care for household income at or below 400% FPL (~$63,840/yr single, ~$132,000/yr family of 4). Sliding-scale discounts for income between 401-650% FPL. Insured patients qualify if out-of-pocket costs exceed 10% of family income.
Contact Financial Counseling
Call (866) 967-4677 or visit the financial counseling office at Santa Clara Valley Medical Center, O'Connor Hospital, or St. Louise Regional Hospital. Counselors can help determine which programs fit your situation, including Medi-Cal.
Gather Your Documents
You only need two things: proof of identity (any government ID, work/school ID, or birth certificate + another ID) and proof of income (pay stubs or tax returns). That's it.
Submit Your Application
You can submit by:
- In person: Financial counseling office at any SCVH hospital or clinic
- Phone: (866) 967-4677
- Online: Healthcare Access Program page
Follow Up
Call (866) 967-4677 to confirm receipt and check your application status. The county will also screen you for Medi-Cal eligibility if appropriate.
Common Pitfalls to Avoid
- Missing the deadline: Apply within 240 days of your date of service.
- Not knowing about insured patient eligibility: Even with insurance, you qualify if out-of-pocket costs exceed 10% of family income.
- Assuming you need to be a citizen: There is no citizenship requirement. SCVH serves all patients regardless of immigration status.
- Paying bills you cannot afford: Contact SCVH immediately to flag your account for financial assistance review. Do not drain savings to pay bills you may not owe.
- Not checking for refunds: In 2024, 43,000 patients were notified they may be owed refunds. Call to check if you overpaid in the past.
Collection Protections (California AB 1020)
California AB 1020 Protections
California law provides strong protections for patients eligible for financial assistance:
- No wage garnishment against patients eligible for financial assistance
- No liens on homes for medical debt
- No lawsuits to collect medical debt from eligible patients
- No adverse credit reporting while an application is pending
HAP vs. AB 1020
The Healthcare Access Program (HAP) is SCVH's own program and is more generous than what California AB 1020 requires. AB 1020 mandates charity care for patients at or below 400% FPL at nonprofit hospitals. HAP goes further by offering sliding-scale discounts up to 650% FPL and keeping documentation requirements minimal.
Medi-Cal Screening
SCVH will also help you apply for Medi-Cal (California Medicaid) if you may be eligible. California now covers undocumented adults through Medi-Cal, so even patients without legal status may qualify for ongoing health coverage beyond just the current bill.
What If You Are Denied?
1. Contact Financial Counseling
Call (866) 967-4677 to discuss the denial. Common reasons include income above 650% FPL, incomplete documentation, or residency outside Santa Clara County.
2. Reapply or Appeal
If your situation has changed or you can provide additional documentation, submit a new application. If you have insurance and your out-of-pocket costs exceed 10% of family income, make sure to highlight this as a qualification path.
3. Explore Other Options
- Medi-Cal: California Medicaid now covers undocumented adults. SCVH can help you apply.
- Payment plan: Request an interest-free payment plan for remaining balance
- Request an itemized bill: Review all charges for errors or overcharges
- California AB 1020: Even if denied HAP, you may still qualify under state law protections
- County ombudsman: As a public system, SCVH has additional accountability channels
Let CareRoute Bill Defense Help
If your application was denied or you need help negotiating your SCVH bill, CareRoute Bill Defense can review your case and negotiate on your behalf at no upfront cost.
Get Help with Your BillCollections Policy
County Tax Collections
Santa Clara Valley Healthcare is a public county hospital. Unlike private hospitals that use third-party collection agencies, SCVH refers unpaid debt to the Santa Clara County Department of Tax and Collections (DTAC). DTAC handles medical collections in-house under a "collectors with compassion" philosophy, sending out 25,000+ billing statements per cycle. A "Goodbye Letter" is sent at least 60 days before referral to DTAC. There is no evidence of debt being sold to outside collection agencies.
Historical Collection Practices
SCVH has historically pursued legal and judicial actions against patients, including wage garnishment through county processes. A 2019 lawsuit alleged the county failed to adequately inform patients about charity care and discount programs. Three patients were billed $8,000 to $35,000 and sent to collections despite likely qualifying for assistance. The case settled in June 2023, resulting in approximately 43,000 former patients being notified of potential eligibility for billing corrections, refunds, and retroactive financial assistance.
California's Strong Protections
California provides the strongest medical debt protections of any state:
- SB 1061 (Jan 2025): Bans medical debt from credit reports entirely. Any medical debt reported to credit bureaus becomes void and uncollectable
- AB 2297 (2025): Hospitals and emergency physicians prohibited from placing liens on real property to collect unpaid medical bills
- AB 1020: Hospitals must wait at least 180 days after the first billing statement before any collection action
- Reasonable payment plans: Hospitals must offer payment plans that do not exceed 5% of a patient's monthly household income
Your Rights
As a public hospital, SCVH is not subject to IRS 501(r) requirements, but California state law provides equivalent or stronger protections. If you received a bill from SCVH that was sent to DTAC collections, you may still be eligible for retroactive financial assistance, especially in light of the 2023 settlement requiring improved patient notification. Contact SCVH financial counseling to apply.
Already in collections? Read our full 7-step collections playbook for strategies to resolve medical debt, dispute errors, and negotiate settlements.
Contact Information
Financial Assistance Phone
Online & In Person
Official Resources
Frequently Asked Questions
Who qualifies for Santa Clara Valley Healthcare financial assistance?
Patients with household income at or below 400% FPL (~$63,840/yr single) qualify for 100% free care through the Healthcare Access Program (HAP). Patients with income between 401-650% FPL qualify for sliding-scale discounts. Insured patients also qualify if out-of-pocket costs exceed 10% of family income. There is no citizenship requirement.
What makes SCVH's program different from other hospitals?
The 650% FPL upper threshold is almost certainly the most generous of any hospital system in the country. A family of 4 earning up to ~$214,500 can still qualify for discounted care. Documentation requirements are minimal (just ID + income proof). There is no citizenship requirement, and as a county system, SCVH cannot turn anyone away.
Does SCVH serve undocumented patients?
Yes. As a county-owned public hospital system, SCVH serves all patients regardless of immigration status. There is no citizenship requirement for financial assistance. Additionally, California now covers undocumented adults through Medi-Cal, and SCVH helps patients apply for this coverage.
Can insured patients get help with their bills?
Yes. If your out-of-pocket costs at SCVH exceed 10% of your family income, you qualify for financial assistance regardless of your insurance status. This is particularly helpful for patients with high-deductible health plans who face large out-of-pocket expenses.
What documents do I need to apply?
Just two things: proof of identity (driver's license, passport, government ID, work/school ID, or birth certificate plus another ID like a gym or Costco card) and proof of income (recent pay stubs or tax returns). This is deliberately minimal compared to private hospital systems.
Am I owed a refund from a past visit?
Possibly. In 2024, Santa Clara Valley Healthcare notified 43,000 former patients that they may have been eligible for charity care or discounts they never received. If you paid out of pocket for care at any SCVH facility in recent years, call (866) 967-4677 to check if you are owed a refund.
Need Help with Your Santa Clara Valley Healthcare Bill?
CareRoute Bill Defense can review your medical bills, identify savings opportunities, and negotiate with SCVH on your behalf. No upfront cost.
Start Your Free Case ReviewThis guide is for informational purposes only and does not constitute legal or financial advice. Information is based on publicly available Santa Clara Valley Healthcare and Santa Clara County financial assistance policies as of 2026. Eligibility requirements, income thresholds, and application processes may change. Always verify current requirements directly with Santa Clara Valley Healthcare at (866) 967-4677 or visit health.santaclaracounty.gov.