Financial Assistance Program

As part of our mission and commitment to a healthier community, Hawaii Pacific Health hospitals and clinics provide financial assistance to patients receiving emergency and/or medically necessary care who qualify for assistance by meeting the eligibility requirements in our Patient Financial Assistance Program Policy (FAP).

Emergency or medically necessary care can be obtained from: Kapiolani Medical Center for Women & Children and Kapiolani Medical Specialists, Kauai Medical Clinic, Pali Momi Medical Center, Straub Medical Center, Wilcox Medical Center.

Eligibility Requirements

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 Hawaii Pacific Health facilities. All Hawaii 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 Hawaii 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, Hawaii Pacific Health representatives will review all available information and make a determination on the patient’s eligibility for financial assistance.


Which Providers are not covered under the program?

Hawaii Pacific Health’s Financial Assistance program applies only to services billed by Hawaii Pacific Health’s hospitals and/or Hawaii Pacific Health employed physicians. Services that are billed by Non-Hawaii 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.


How can I get program information?

Copies of Hawaii 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 Hawaii Pacific Health’s website, by email, in person, by telephone, or by U.S. postal mail.

Download program information:  Electronic copies of program information are available:

Patient Financial Assistance Program Policy (English) Cantonese, ChuukeseIlokano, Japanese,
Korean, Mandarin, Marshallese, SamoanTagalog, Vietnamese
Plain Language Summary (English) Cantonese, ChuukeseIlokano, Japanese,
Korean, Mandarin, MarshalleseSamoanTagalog, Vietnamese
Program Application (English) Cantonese, ChuukeseIlokanoJapanese,
KoreanMandarin, Marshallese, SamoanTagalog, Vietnamese

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 Oahu or 866-266-3935 from the neighbor islands Monday - Friday, 8 a.m.-4:30 p.m.

By Email:

By Mail:

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

Need help?

For help or for questions about Hawaii Pacific Health’s Financial Assistance application process or other questions, please call 808-522-4013 on Oahu 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. You may also check our Frequently Asked Questions page for additional information. 

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Financial Assistance Program FAQ

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