Patient Rights

California Patient Billing Rights

Know your rights as a patient in California. From surprise billing protections to financial assistance programs, here's what the law says about your medical bills.

Surprise Billing Financial Assistance Additional Rights File a Complaint

Protection

Surprise Billing Protections

AB 72 & AB 1611 — California has comprehensive surprise billing protections through AB 72 (2017) and AB 1611 (2022). Patients are protected from balance billing for emergency and non-emergency services at in-network facilities.

AB 72 prohibits out-of-network providers at in-network facilities from balance billing patients — effective since 2017.
Patients pay only their in-network cost-sharing amount for surprise out-of-network care.
Emergency services are protected regardless of network status under both state and federal law.
AB 1611 extended protections to ground ambulance services beginning 2023.
California's independent dispute resolution process handles billing disputes between providers and insurers.

What this means for you

If you receive a surprise out-of-network bill, you are not responsible for the balance beyond what you'd pay for in-network care. Contact your insurer and reference the AB 72 & AB 1611 to dispute any balance bill.

Review your bill →

Assistance

Financial Assistance & Charity Care

Under Hospital Fair Pricing Act (SB 1276 & AB 774), hospitals in California must provide financial assistance to qualifying patients.

Nonprofit hospitals must have written financial assistance (charity care) policies.
Patients at or below 400% FPL (~$124,800 for a family of four) are eligible for charity care at nonprofit hospitals.
Hospitals cannot charge uninsured patients more than the amount paid by the largest government payer (usually Medicare/Medi-Cal).
All hospitals must offer interest-free payment plans to eligible patients.
Hospitals must provide financial assistance application forms in the patient's preferred language.

How to apply

Ask the hospital's billing department for a financial assistance application.
Gather proof of income (pay stubs, tax return, benefit letters).
Submit the application — you can often do this even after receiving a bill.
If denied, appeal the decision and contact your state insurance department.

Know Your Rights

Additional Patient Rights in California

Beyond surprise billing and financial assistance, California law provides these important protections.

Price Transparency

All hospitals must post a list of their standard charges online — shoppable services and full chargemaster, per CMS requirements.

Emergency Care

Under EMTALA and California law, emergency departments must provide stabilizing treatment regardless of ability to pay or insurance status.

Medi-Cal Protections

Medi-Cal patients have zero cost-sharing for covered services. Providers cannot bill Medi-Cal patients for the difference between their charge and the Medi-Cal rate.

Debt Collection Limits

Hospitals must wait at least 150 days after the first bill before sending medical debt to collections. They must make reasonable efforts to determine if patients qualify for financial assistance first.

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