Children’s Hospital Los Angeles recognizes that many people in our community require medically necessary health care services, but are uninsured, underinsured, ineligible for government health programs or otherwise without adequate financial resources to pay for health care services.
CHLA is committed, to the extent of its financial ability, to make medically necessary services available for those not able to pay. To manage its resources responsibly and to allow CHLA to provide the appropriate level of assistance to those in need, CHLA has adopted the following guidelines for the provision of Charity Care and Discounted Care.
Financial Assistance Policy
Learn more about our Financial Assistance policy (English)
Conozca nuestra política de Asistencia Financiera (Español)
Plain Language Guide
Financial Assistance with Hospital Bills (English)
Ayuda Financiera Para Facturas Del Hospital (Español)
(Arabic) تعرف أكثر على وثيقة المساعدات المالية الخاصة بنا
Իմացե՛ք ավելին մեր Ֆինանսական Օգնության Քաղաքականության մասին (Armenian)
저희 재정 지원 방침에 대해 더 알아 보세요 (Korean)
Tìm hiểu thêm về Chính Sách Hỗ Trợ Tài Chính của chúng tôi (Vietnamese)
How to Apply for Financial Assistance
In order for us to consider your account for financial assistance, you must complete, sign and return the application for uncompensated care.
Application for Uncompensated Care
Please include all documents as requested on the application and a copy of your ID.
You will need to provide:
- Bank statements for the past 3 months
- Copy of last 3 months’ pay stubs
- Copy of last year’s tax return
- Rental receipt or proof of monthly mortgage payment
- Copy of any government benefits being received
If you are unemployed and have no source of income, please send us a detailed letter from the person who is providing you with free room and board. They will not be responsible for your bills.
Your Application for Uncompensated Care will not be evaluated if the requested information is not provided or not thoroughly completed.
If you have any questions regarding this application, please contact us at 800-404-6627. We are available to assist you Mondays through Fridays from 8 a.m. to 5 p.m.
Return your completed application and attachments to:
Children’s Hospital Los Angeles
Patient Business Services
4650 Sunset Blvd., #26
Los Angeles, CA 90027
Application in Other Languages
(Letter in Arabic) الخطاب باللغة العربية
(Application in Arabic) الطلب باللغة العربية
Նամակ հայերեն լեզվով (Letter in Armenian)
Դիմում հայերեն լեզվով (Application in Armenian)
繁體中文信件 (Letter in Traditional Chinese)
繁體中文申請書 (Application in Traditional Chinese)
서신(한국어) (Letter in Korean)
신청서(한국어) (Application in Korean)
Carta en español (Letter in Español)
Solicitud en español (Application in Español)
Thư bằng Tiếng Việt (Letter in Vietnamese)
Đơn bằng Tiếng Việt (Application in Vietnamese)
Updated Aug. 11, 2022