Our Mission at Hoag Orthopedic Institute
Our mission is to provide the highest quality health care services to the
communities we serve, including Orange County and the surrounding areas.
At Hoag Orthopedic Institute, we believe this means providing affordable
and accessible treatment options, even for those without coverage.
What is the Patient Financial Assistance Program?
Hoag Orthopedic Institute’s Financial Counseling Department offers
free financial screenings for people who don't have health insurance
and can't pay their hospital bills. This also extends to patients
who have insurance but are unable to pay the portion of the bill insurance
Our financial counselors will review your eligibility for Medicare, Healthy
Families Program, Medi-Cal, or other coverage offered through the California
Health Benefit Exchange, California Children’s Services program,
other state- or county-funded health coverage, or charity care to find
a solution that works. If you already have coverage through one of these
programs, please notify our financial counselors immediately. Patients
ineligible for government assistance may still qualify for discount or
charity programs available through Hoag Orthopedic Institute.
View Hoag Orthopedic Institute’s Financial Assistance and Charity
How & When to Apply for Assistance
Please contact our financial counselors immediately after discharge or
completion of services by calling (949) 764-5564 or by e-mail at
We can assist with your application and provide the applications needed
for Medicare, Healthy Families Program, Medi-Cal, or other coverage offered
through the California Health Benefit Exchange, California Children’s
Services program, or other state or county-funded health coverage. You
may also be referred to www.OCGOV.com for local assistance with your medical bills.
Whether you lack or have inadequate insurance, if you meet the low or moderate-income
requirements, you may qualify for discounted payment or charity care.
Please remember that access to necessary health care is not affected by
eligibility for financial assistance. Hoag Orthopedic Institute is committed
to treating all those who come to us for care.
Financial Assistance and Charity Care Applications & Forms:
You may also apply directly for the above programs by accessing their website
Supporting Charity Application Documentation
Please also provide these additional documents for single or both applicants,
- 2 recent paycheck stubs
- 2 recent bank statements
- Copy of your most recent cancelled rent check, lease agreement or mortgage payment
- Copy of bank statements (checking / savings)
- Copy of your disability, social security payment statement, unemployment
notice of eligible benefits and bank statement reflecting deposits
- If you do not have a source of income or proof of income, please provide
a letter explaining how you support yourself and your family.
- Written, signed statement from a family member or friend who is proving
your room and board and/or income.
- Copy of your most recent 1040 tax return or W2
If your most recent 1040 tax return is not available, we will need one
of the following:
- Social Security Awards Letter
- Proof of non-filing from the IRS (call 800-829-1040 to obtain a copy)
- A signed letter explaining why you have not filed a federal tax return
or have requested an extension for taxes.
Call Hoag Orthopedic Institute’s Charity Care Specialist at (949)
764-8413 if any questions.
Secure Fax: 949-764-7246
Patient Financial Services
2975 Red Hill Ave, Suite 200
Costa Mesa, CA 92626
Attn: Charity Care Specialist
We understand that the need for financial assistance can be a sensitive
and deeply personal issue and are committed to maintaining the confidentiality
of all requests, information, and funding.
For more information please contact one of our financial counselors at
(949) 764-5564, we are available Monday through Friday from 8:30 AM to
4:30 PM, or by e-mail at