Our Financial Assistance Program (FAP) is designed to help low-income, uninsured, or underinsured patients who need help paying for all or part of the medical care they received at any of our Hawaiʻi Pacific Health facilities. All Hawaiʻi residents, including those with insurance, are eligible to apply for financial assistance. Non-residents are eligible to apply for financial assistance for emergency care.

Established guidelines are utilized to determine what amount, if any, will qualify for financial assistance.

Financially Indigent:  Patients with family income at or below 200 percent of the Federal Poverty Guidelines (FPG) for the State of Hawaiʻi will receive a 100 percent discount (free care). Patients with family incomes ranging from more than 200 percent up to 400 percent of FPG will receive an 85 percent discount on their current balance.

Medically Indigent:  Patients with incomes higher than 400 percent of FPG who have a balance due that is 15 percent or more of their combined annual family income and liquid assets may be eligible for an 85 percent discount on their current balance.

Please refer to the FAP for a complete description of program eligibility requirements.

When a patient’s circumstances do not satisfy the requirements under the established discount guidelines, a patient may still be able to obtain financial assistance. In these situations, Hawaiʻi Pacific Health representatives will review all available information and make a determination on the patient’s eligibility for financial assistance.

Hawaiʻi Pacific Health’s Financial Assistance program applies only to services billed by Hawaiʻi Pacific Health’s hospitals and/or Hawaiʻi Pacific Health employed physicians. Services that are billed by Non-Hawaiʻi Pacific Health providers are not eligible under our FAP. View the list of providers in HPH hospitals that are not covered by our Financial Assistance policy.

Charges for Emergency or Medically Necessary Care: Patients who qualify for financial assistance will not be charged more for emergency or other medically necessary care than amounts generally billed (AGB) to patients who have insurance.

Copies of Hawaiʻi Pacific Health’s Patient Financial Assistance Program (FAP) policy, application form, instructions and checklist, as well as our plain language summary (e.g., policy summary) are available, without charge, from Hawaiʻi Pacific Health’s website, by email, in person, by telephone, or by U.S. postal mail.

In Person:  The Financial Services Office at each hospital has financial counselors available to help with the application process.

Over the Phone:  Call 522-4013 on Oʻahu or 866-266-3935 from the neighbor islands Monday - Friday, 8 a.m.-4:30 p.m.

By Email:  [email protected]

By Mail:

Hawaiʻi Pacific Health – Customer Service
888 South King St.
Honolulu, HI 96813  

For help or for questions about Hawaiʻi Pacific Health’s Financial Assistance application process or other questions, please call 808-522-4013 on Oʻahu or 866-266-3935 from neighbor islands M-F, 8 a.m-4:30 p.m., or speak to a Financial Counselor at any of our hospitals. 

Find Answers to Your Financial Assistance Questions

Hawaiʻi Pacific Health provides financial assistance to patients receiving emergency and/or medically necessary care who qualify for assistance pursuant to our Financial Assistance Policy. This assistance is available to the insured and uninsured based on income and personal circumstances. Here are some answers to the most frequently asked financial assistance questions for patients treated at Hawaiʻi Pacific Health (“HPH”) facilities:

Download the Financial Assistance Application. To obtain a translated version of the application, contact the Financial Services desk at any of our facilities. Or, call Customer Service at (808) 522-4013 on Oʻahu or (866) 266-3935 from neighbor islands M-F between 8 a.m. and 4:30 p.m.

You can apply before you have an appointment, when you come to the hospital or clinic to get care, when the bill is received or afterwards. Financial Assistance is generally approved for a six month period.

Eligibility is determined by measuring the family income against current poverty income guidelines established by the Federal Government for the state of Hawaiʻi.

Applicants for Financial Assistance may be screened for Medicaid eligibility by a hospital Financial Counselor. Financial Assistance applications must be completed and submitted with wage/income statements for the past 90-days and a copy of the Medicaid denial letter if applicable. 

Individuals who do not reside in Hawaiʻi and require emergency services from HPH may receive care and get a discount if they meet the financial requirements and complete the financial assistance application process. Individuals who are Hawaiʻi residents may get a discount on non-emergency, medically necessary services, if they meet the financial requirements and complete the financial assistance application process.

Applications are usually processed within 30 calendar days, once all required documentation has been received by Hawaiʻi Pacific Health. Please see the application checklist for a list of required documentation.

A determination of eligibility will be based on information provided. You will be mailed a letter notifying you of the determination:

• 100% approval
• Partial Approval: Those who are approved for financial assistance with income that exceeds 200% of the federal poverty guidelines
• Denial: Denials are based on information provided by the patient and will be specific as to what financial criteria the patient did not meet. Denials related to missing information or incomplete information will be reconsidered once the information is provided.

Call Customer Service at (808) 522-4013 on Oʻahu or (866) 266-3935 from neighbor islands M-F between 8:00 a.m and 4:30 p.m.

The discount will cover those charges for emergency or medically necessary services which are billed directly by a Hawaiʻi Pacific Health Facility or by an employed Hawaiʻi Pacific Health physician. Physicians NOT covered by HPH’s financial assistance discount are noted on the Provider Exclusion List.

Hawaiʻi Pacific Health determines your level of financial assistance based on your family income and circumstances. If you qualify for partial assistance, the remaining balance of the bill is your responsibility to pay. To learn more about available payment options, please contact the Financial Counselors at any of our facilities or call Customer Service at (808) 522-4013 on Oʻahu or (866) 266-3935 from neighbor islands M-F between 8:00 a.m. and 4:30 p.m.

In general, patients must reapply every 6 months.

Yes. Please contact our Customer Service department so we can help facilitate the process. We work very closely with our collection agencies and will notify them if you are approved for financial assistance.

No single organization can meet the needs of all patients who are unable to pay. Patients in need of financial assistance should utilize all resources for which they are eligible. This ensures Hawaiʻi Pacific Health facilities will have resources available to assist patients who don’t qualify for other financial help.

Please see the Provider Exclusion List for non-covered physicians.

Hawaiʻi Pacific Health uses the tax return to verify personal financial information such as income and household size.

Yes. Please include a letter explaining the circumstance.

Please send us copies of the forms as originals are NOT returned.

Assuming all criteria are met and the services you received were medically necessary, you may qualify for financial assistance for the portion of the bill which your insurance carrier has determined to be your responsibility.

To be considered to be a Hawaiʻi resident, must be in the state for other than temporary or transitory purposes for at least 30 days.