Financial Assistance Policy Plain Language Summary Seton Medical Center, a not for profit acute care hospital, was established to serve the needs of the community. The hospital is committed to providing medical services to patients regardless of their ability to pay. Seton Medical Center recognizes that not all patients have the financial resources to pay their hospital bill. This Plain Language Summary provides that basic information about our policy.

Seton Medical Center Financial Assistance Policy

The Financial Assistance Program offers emergency and other medically necessary services at low cost or no cost to qualified patients. Whether patients are uninsured or underinsured, they can apply for financial assistance. Our staff will assist individuals in applying for eligible government health insurance programs and completing the financial assistance application, free of charge. Upon approval, patients may receive the following assistance:

0-200% of the Federal Poverty Level: 100% of patient balance

201-350% of the Federal Poverty Level: Patient balance discounted using lesser of the amount generally billed to a patient with insurance coverage OR the amount of payment the hospital would be paid by a government program, such as Medicare, Medi-cal or other government sponsored health programs.

How to obtain copies of our Financial Assistance Policy and Applications

You may obtain a copy of our policy and application form free of charge in the following ways:

• Seton Medical Center’s website: seton.verity.org

• Visit our Eligibility and Enrollment Department at: Seton Medical Center 1900 Sullivan Ave Daly City, Ca 94015 Phone (888) 874-2585

Financial Assistance Policies, Applications and Plain Language Summaries are available in the following Languages: English, Spanish, Chinese and Tagalog.