Financial resources & assistance

Emanate Health is committed to making health care available to everyone in our community, regardless of their ability to pay. Our financial assistance program helps low-income, uninsured or underinsured patients who need help paying for all or part of their medically necessary care.

Emanate Health has financial counselors available on-site to assist you with any eligibility questions for local and state programs, including county and Medicaid.

For questions regarding Emanate Health's financial assistance policy or to request assistance in completing the financial assistance application, please contact our Business Office at 626.732.3100.

• Financial Assistance Summary—English
• Financial Assistance Summary—Spanish
• Financial Assistance Summary—Chinese
• Financial Assistance Application—English
• Financial Assistance Application—Spanish
• Financial Assistance Application—Chinese

• Charity Care Policy—English
• Charity Care Policy—Spanish
• Charity Care Policy—Chinese

• Collection of Self Paid Patient Accounts Policy
• Amounts Generally Billed (AGB)—English
• Amounts Generally Billed (AGB)—Spanish
• Amounts Generally Billed (AGB)—Chinese

The calculators below are intended to provide you an estimate for your bill from the Hospital. You may receive separate bills for physician services you receive during your stay. THIS IS AN ESTIMATE ONLY. YOUR ACTUAL BALANCE AMOUNT DUE MAY BE DIFFERENT. This estimate is for hospital charges for anticipated care and recovery, taking into consideration insurance coverage, co-payments, deductibles, coinsurance, and other information that may affect personal out-of-pocket costs. Actual charges on the final hospital bill may vary from the estimate, based on the patient’s medical condition, unknown circumstances or complications, final diagnosis, and treatment ordered by the attending physician(s).

This estimate covers hospital charges only and does not include professional fees for services such as those provided by a physician, radiologist, pathologist, anesthesiologist, nurse practitioner or other independent practitioner. Persons with insurance should contact their health benefits administrator for the most accurate information regarding plan structure, deductibles, co-payments, and any other factors that might affect personal liability for anticipated health care services.

Physicians or other practitioners who provide professional services may not participate in an individual patient’s health benefit plan. Please be advised that while the Hospital attempts to estimate the cost of hospital charges as accurately as possible, there may be significant variations between the estimate provided and the actual charges. Accordingly, the Hospital makes no representations, express or implied, and disclaims any and all liability, as to the accuracy of this estimate.

Calculators

• Inter-Community Hospital
• Queen of the Valley Hospital
• Foothill Presbyterian Hospital

• Inter-Community Hospital (& Queen of the Valley Hospital)*
• Foothill Presbyterian Hospital

To save the above documents to your computer:

• Right click on the document link
• Select (left click) "Save link as..."
• Navigate to the appropriate file on your computer and save the document

(Files posted 3/18/24)

*Inter-Community Hospital and Queen of the Valley Hospital share the same pricing

The Hospital Bill Complaint Program is a state program, which reviews hospital decisions about whether you qualify for help paying your hospital bill. If you believe you were wrongly denied financial assistance, you may file a complaint with the Hospital Bill Complaint Program. Go to HospitalBillComplaintProgram.hcai.ca.gov for more information and to file a complaint.