Our Charity Care Policy

St. Luke’s, a social purpose professional medical practice consistent with the Catholic tradition, primarily serves the medical needs of uninsured individuals and families (Recipients).

The Charity Care goals of St. Luke’s are:

  • To connect uninsured qualifying Recipients with existing programs.
  • To provide free primary care to those who do not qualify for government healthcare programs and cannot afford, or do not otherwise have access to, private health care insurance coverage.

Providing free health care services to the uninsured is the public commitment of our physicians and our Board of Directors to our Benefactors and to the greater community.

Purpose

This policy serves to establish and ensure a fair and consistent method for the review and completion of requests for charitable medical care to our patients in need.

Measures to Publicize St. Luke’s Charity Care Policy

St. Luke’s is committed to offering Charity Care to eligible patients who do not have the ability to pay for their medical services in whole or in part. In order to accomplish this charitable goal, St. Luke’s sites will widely publicize this Policy in the communities that the individual St. Luke’s affiliated sites serve.

St. Luke’s affiliated sites will make a copy of this Policy available by posting it on their webpage including the ability to download a copy of the Policy free of charge. Individuals in the community served will be able to obtain a copy of the Policy in locations throughout each St. Luke’s affiliated site or upon request.

Limitations

St. Luke’s Charity Care does not include all costs that may be associated with medical services.

The following is a non-exhaustive list of items or services that are not included in our Charity Care program:

  • Transportation and Lodging: The patient is responsible for transportation to and from St. Luke’s.
  • Pharmacy Supplies: St. Luke’s does not pay for prescription medications or supplies, but will prescribe generic medications whenever possible and will assist patients to complete Patient Assistance Programs provided by pharmaceutical manufacturers.
  • Home Health Care is not covered under this policy.
  • As a benefit to Recipients, ancillary services (specialist care, lab tests, imaging, et al) may be coordinated through St. Luke’s to other providers at reduced rates. St. Luke’s will not benefit financially from any ancillary service fees collected from Recipients and paid to ancillary service providers. NOTE: St. Luke’s can provide limited funds in certain situations. The funds are generally less than $50, offered once, and for short-term situations.

Identification of Patients Who May Be Eligible

There are a number of ways a patient can be access or be referred for St. Luke’s Charity Care. Following is a non-exhaustive list of examples for identification prior to receiving services:

  • Patients or their representatives may request Charity Care.
  • St. Luke’s employees may refer patients.
  • Non-St. Luke’s physicians and hospitals may refer patients.
  • Local government agencies may refer patients.

Eligibility Criteria Considered for Charity Care

St. Luke’s informs all patients how to receive free Charity Care: the patient must indicate they do not have private health care insurance available through their employer.

St. Luke’s will see the patient for their first visit and requests they provide proof of their completed application and/or denial of eligibility before subsequent visits.

In determining whether an individual qualifies for continuing charity care, other county or governmental charitable service programs will be considered. Many applicants are not aware that they may be eligible for public health insurance programs or have not pursued application.

To continue to receive Charity Care at St. Luke’s and patients must apply for full-scope Medi-Cal and ACA subsidized insurance through Covered California. Multiple options (in-person, online, phone call) will be provided to help the patient complete the Covered California application.

St. Luke’s requires compliance with the application process of appropriate service organizations that may provide coverage for care, such as full-scope Medi-Cal and Covered California and patients will be required to re-apply for full-scope Medi-Cal and subsidized insurance during Covered California open enrollment.

Reasons for Denial

St. Luke’s may deny requests for Charity Care for a variety of reasons including, but not limited to:

  • Failure to prove completion of application for full-scope Medi-Cal and/or Covered California subsidized insurance
  • Failure to prove denial of full-scope Medi-Cal and/or Covered California subsidized insurance.
  • Patient becomes qualified for full-scope Medi-Cal or subsidized insurance through Covered California.
  • Discharge of patient from the practice for reasons following our Discharge policy.
  • Noncompliance with treatments recommended by the practice, physician, or other healthcare provider.
  • Threatening or abusive behavior directed at office staff, physicians, other healthcare providers, or patients.
  • The patient is deceptive or lies.
  • The patient abuses medication.

Equal Opportunity

St. Luke’s is committed to upholding the multiple federal and state laws that preclude discrimination on the basis of race, sex, age, religion, national origin, marital status, sexual orientation, disabilities, military service, or any other classification protected by federal, state or local laws.

Confidentiality

St. Luke’s staff will uphold the confidentiality and individual dignity of each patient. St. Luke’s will meet all HIPAA requirements for handling personal health information.