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Charity Care

Charity CareWhat is Charity Care?

Help for low income individuals and families with EMS expenses. Charity Care is either free care or reduced-price care, depending on income level for EMS charges.

Who is eligible?

Non SJCPHD District Resident Individuals and families within the stated income guidelines if:

  1. Demonstrated inadequate financial resources to pay for care; and
  2. Out of pocket expenses not covered by a group or individual medical plan, worker’s compensation, Medicare, Medicaid, or any other state, federal, or military program; and
  3. Not involved in a situation where someone else has a legal responsibility to pay for the costs of medical services — for example, an auto accident or workplace injury.

What does it cover?

Charity Care covers the out of pocket costs associated with EMS treatment and/or transport for those who qualify.

How is my case determined?

Each case is determined separately based on its own merits. The greater the amount of information that is provided, the faster a determination can be made. Generally, those at or below 120% of the current Federal Poverty Level Guideline (FPL) could receive no out of pocket cost care while those between 121% and 200% of the FPL could receive reduced cost care.

How do I apply?

  1. Download the EMS Charity Care Program Application: PDF | Microsoft Word
  2. Complete the application and attach the requested forms and paperwork requested.
  3. Do not send form without required attachments.