Request for Medical Financial Assistance

A copy of this confirmation will be sent to your email that we have on file. It may take up to 30 business days for your application to process before you’ll receive a confirmation.

After Kaiser Permanente reviews your completed application, we will advise, via letter, if you have been approved or denied. Please note; we may need additional information from you before we can make a final decision.

For more information, return to the Medical Financial Assistance Program.

At Kaiser Permanente, we believe in total health, including social health. Social health means having things like healthy food, a safe place to live, ability to pay for utilities, and more. To get help with these essentials and find resources and programs in your community, visit the Kaiser Permanente Community Support Hub™ .