San Diego Hospital Charity Care 2026–27: UC San Diego Health, Sharp and Scripps Financial Assistance, the 400% Income Rule and How to File a State Complaint

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If you live in San Diego County and owe a hospital, California law is more on your side than most patients realize. Under the state's Hospital Fair Pricing Act, a family of four earning up to $132,000 a year (400% of the 2026 federal poverty guideline) can qualify for free or discounted hospital care. Uninsured patients at that income level at UC San Diego Health and Sharp generally get the whole bill wiped out. Hospitals cannot set deadlines to keep you from applying, and they cannot report hospital debt to credit bureaus.

This guide starts with the state rules every California hospital has to follow. Then it covers the three big San Diego systems (UC San Diego Health, Sharp HealthCare and Scripps Health), what each one asks for, and how to file a complaint with the state if you are wrongly denied.

The California Rules That Apply to Every Hospital

California's Department of Health Care Access and Information (HCAI) enforces the Hospital Fair Pricing Act through its Hospital Bill Complaint Program. HCAI's guidance says:

Who is eligible. Anyone who meets both of these tests:

You are a self-pay patient (uninsured, or your injury is not covered by workers' comp, auto or other insurance) or you have high medical costs, and
Your family income is not more than 400% of the federal poverty level.

Hospitals may choose to help people with incomes above 400% too, so read each hospital's policy.

What counts as "high medical costs." HCAI lists three ways:

your out-of-pocket costs at the hospital in a year are more than 10% of your current family income or your family income over the prior 12 months, whichever is lower
your out-of-pocket medical expenses (anywhere) are more than 10% of family income, and you document what your family paid in the prior 12 months
a lower threshold set by the hospital's own policy

Immigration status does not affect eligibility, according to HCAI.

What proof you need. HCAI says acceptable income documents are income tax returns for the year you were first billed or the 12 months before, or pay stubs from within six months before or after the hospital first billed you. Since 2025, hospitals can also accept other income documents when tax returns or pay stubs are not available.

Newer protections (AB 1020, AB 2297 and SB 1061). HCAI's summary of the laws says they:

raised the income limit from 350% to 400% FPL
prohibit adverse credit reporting of hospital debt
prohibit application deadlines. Eligibility can be decided whenever the hospital receives your income documents.
stopped hospitals from counting your savings and other monetary assets when deciding eligibility
ban requiring you to apply for other coverage before you can get a discount payment
prohibit liens on, or the sale of, a patient's real property to collect hospital bills
restrict when hospitals can sell patient debt, including requiring that the patient was found ineligible or did not respond for 180 days

Charity care vs. discount. Charity care is free care. A discount payment is a reduced charge, so you still owe part of the bill. If you were denied charity care, HCAI says you may still qualify for a discount if you are at or below 400% FPL. Under a discount, the hospital limits what it expects you to pay to roughly what it would get from Medicare or Medi-Cal, whichever is greater.

What 400% of the Poverty Guideline Means in Dollars

UC San Diego Health publishes its 2026 income limits at 400% of the federal poverty guidelines:

Family size	400% FPG income limit (2026)
1	$63,480
2	$86,560
3	$109,280
4	$132,000
5	$154,720
6	$177,440
7	$200,160
8	$222,880

For each additional person above eight, add $22,720.

UC San Diego Health

Who qualifies: uninsured patients with family income at or below 400% FPG generally qualify for a 100% discount. Insured patients at or below 400% FPG with high medical costs (out-of-pocket costs above the lesser of 10% of current or prior-12-month family income) may also qualify.

How to apply:

Get the application online or by calling 855-827-3633 (9 a.m. to 4:30 p.m., Monday to Friday).
Include required documents, including a copy of your individual tax return (Form 1040) for the current tax year.
Return it to UC San Diego Health, Financial Assistance Team, 6200 Greenwich Drive, Suite 300, San Diego, CA 92122, by fax to 619-471-0403, or by email to patientfinassist@health.ucsd.edu.

Sharp HealthCare

Who qualifies: Sharp says all uninsured patients with family income at or below 400% of the most recent federal poverty level qualify for full charity care. Insured patients with high medical costs can apply for its discount program.

How to apply:

Fill out Sharp's standardized application, request one at 858-499-2400 (Monday to Friday, 8 a.m. to 4:30 p.m.), or apply in the Sharp app under Billing, then Financial Assistance.
Send copies, not originals: your current-year Form 1040 or your two most recent pay stubs.
Mail to Sharp HealthCare Private Pay Unit, PFS/ICD 3rd Floor, 8695 Spectrum Center Blvd., San Diego, CA 92123, fax 858-636-2368, or email SPE.PFSFinancialAssistance@sharp.com.

Scripps Health

Who qualifies: Scripps describes these tiers:

Financial assistance (charity care): uninsured patients earning less than 250% FPL. Scripps fully forgives the bill.
Discounted payment: patients earning between 251% and 400% FPL. Scripps forgives part of the bill and will not charge qualified patients more than it generally bills Medicare patients for emergency or medically necessary care.
Self-pay program: discounts for all uninsured patients, regardless of income.
Payment plans: interest-free, extended payment plans.

How to apply: apply in MyScripps (Menu, then Billing), or download the application and mail, fax or upload it. You can also request one at 877-727-4777 or at a Scripps admitting department. Mail to Attn: Patient Financial Services, 10790 Rancho Bernardo Road, 4S-205, San Diego, CA 92127, or fax 858-927-5070.

ER doctors bill separately. Scripps notes that emergency physicians bill separately from the hospital, and that they are also required by law to give discounts to uninsured or high-cost patients at or below 400% FPL. Apply to the physician billing company too.

A Five-Step Plan

Collect every bill, including separate ER physician, radiology or anesthesia bills.
Find your FPL percentage using the table above or HCAI's online calculator.
Apply to each provider that billed you, using its own form. Attach a tax return or recent pay stubs.
Ask about Medi-Cal and Covered California. Scripps lists a Medi-Cal application line at 866-262-9881 and Covered California at 800-300-1506.
Wait for the written decision. HCAI says hospitals must send you an eligibility determination letter saying whether you were approved or denied.

If the Hospital Says No

Check the reason against the law. A denial for "missing the deadline" conflicts with the rule that eligibility can be decided whenever the hospital gets your income documents. A denial because you have savings conflicts with the ban on counting monetary assets.
Ask about a discount if charity care was denied. If you are at or below 400% FPL, you may still qualify.
File a complaint with HCAI's Hospital Bill Complaint Program. File online through the Patient Complaint Portal, or mail a Patient Complaint Form to Department of Health Care Access and Information, Hospital Bill Complaint Program, 2020 West El Camino Avenue, Suite 1101, Sacramento, CA 95833. Include supporting documents. You must already have applied to the hospital for HCAI to investigate an eligibility decision. If the complaint succeeds, you may be entitled to reimbursement plus interest for anything you overpaid.
Get free advocacy. HCAI points patients to the Health Consumer Alliance at 1-888-804-3536.