If you received care at a Sutter Health hospital and cannot afford the bill, California law requires Sutter to offer free or deeply discounted care based on your income. As of 2026, patients earning up to 400% of the Federal Poverty Level (FPL) qualify for some form of financial assistance under California's Hospital Fair Pricing Act (Health and Safety Code sections 127400 through 127446). That covers a family of four earning up to $132,000 per year.
Quick Answer: Sutter Health offers full charity care (zero cost) to uninsured patients at or below 200% FPL and partial discounts from 201% to 400% FPL. Insured patients with high medical bills can also qualify. There is no application deadline. You can apply before, during, or after treatment with no time limit.
This guide walks through exactly how the California Fair Pricing Act applies to Sutter Health, what the 2026 income thresholds look like by household size, and how to submit an application today.
What the California Fair Pricing Act Requires of Sutter Health
California's Hospital Fair Pricing Act has been in place for over a decade, but AB 2297 (signed into law in 2024, effective January 1, 2025) added significant new patient protections. Sutter Health, as one of California's largest nonprofit health systems operating dozens of hospitals across Northern and Central California, must comply with all requirements.
Under the 2026 framework, California's Fair Pricing Act requires Sutter Health to:
- Offer full charity care to uninsured patients whose income falls at or below 200% of the Federal Poverty Level (FPL)
- Offer partial discounts for uninsured patients with income between 201% and 400% FPL
- Extend financial assistance to insured patients whose annual medical expenses exceed 10% of their family income and whose income is at or below 400% FPL
- Accept applications at any time, with no deadline, including after receiving a bill
- Prohibit wage garnishment, property foreclosure, and bench warrants related to unpaid hospital bills
- Not require patients to apply for other insurance coverage first before being considered for charity care (this is a 2025 change under AB 2297)
- Accept alternative documentation of income beyond tax returns or pay stubs (also new in 2025)
Additionally, under AB 2297's 2025 changes, hospitals can no longer count most monetary assets against you during the eligibility determination. If you have savings or retirement accounts, Sutter cannot use them to disqualify you from financial assistance.
The California Department of Health Care Access and Information (HCAI) at hcai.ca.gov oversees compliance and publishes all hospital fair pricing policies publicly.
2026 Income Limits for Sutter Health Financial Assistance
The following table uses the 2026 Federal Poverty Level guidelines published by the U.S. Department of Health and Human Services at aspe.hhs.gov. California uses the standard 48-state FPL tables.
California Sutter Health Financial Assistance Income Thresholds (2026)
| Household Size | 200% FPL (Full Charity Care) | 400% FPL (Partial Discount Ceiling) |
|---|
| 1 | $31,920 | $63,840 |
| 2 | $43,280 | $86,560 |
| 3 | $54,640 | $109,280 |
| 4 | $66,000 | $132,000 |
| 5 | $77,360 | $154,720 |
| 6 | $88,720 | $177,440 |
| 7 | $100,080 | $200,160 |
| 8 | $111,440 | $222,880 |
| Each additional | +$11,360 | +$22,720 |
Table notes: California Sutter Health Financial Assistance Income Thresholds, based on 2026 HHS Poverty Guidelines. Figures are annual gross household income. Insured patients may also qualify if their out-of-pocket medical costs in the prior 12 months exceeded 10% of household income.
Sutter Health's policy provides:
- Full charity care at 0% to 200% FPL (no patient payment required)
- Sliding-scale discount at 201% to 400% FPL (you pay a reduced amount based on your exact income and household size)
- Interest-free payment plans for all patients regardless of income
If you already received care at Sutter and your bill looks wrong, run it through the CoveredUSA Bill Analyzer before applying for charity care. The CoveredUSA Bill Analyzer compares each charge on your Sutter bill against the Medicare reference rate to flag overbilling and identify specific line items worth disputing, which can lower your balance before you even fill out a charity care application.
Who Qualifies: Key Eligibility Rules for 2026
California's Fair Pricing Act covers patients at Sutter Health hospitals. Outpatient services, physician fees billed by Sutter Medical Group, and surgical centers may have separate policies, so it is worth asking specifically about "hospital financial assistance" when you call.
You may qualify if any of these apply:
- You are uninsured and your income is at or below 400% FPL
- You have insurance but your remaining out-of-pocket costs are high (above 10% of annual income) and your income is at or below 400% FPL
- You are underinsured and cannot reasonably pay the patient-responsibility portion of your bill
What Sutter Health cannot count against you (as of 2025):
- Bank savings or investment accounts (monetary assets are now excluded under AB 2297)
- Health savings account (HSA) balances, except when negotiating a repayment plan
- Your home equity or real property
What income Sutter Health does count:
- Wages, self-employment income, Social Security benefits, pension payments, rental income, and similar regular income streams
- Income of all family members living in the household
How to Apply for Sutter Health Financial Assistance in California
Enrollment window: Open year-round with no deadline. You can apply before receiving care, at the time of service, or after you receive a bill.
Step 1: Request an application. Call Sutter Health Patient Financial Services at (855) 398-1633. You can also download the Charity Care and Discount Payment Application directly from Sutter's billing page at sutterhealth.org/billing-insurance/financial-assistance or from the HCAI Hospital Fair Pricing Policy Lookup tool at hcai.ca.gov.
Step 2: Gather your income documentation. Sutter accepts multiple forms of proof since the AB 2297 changes. Standard documents include your two most recent pay stubs and your most recent federal tax return. If you are self-employed, recently lost a job, or lack formal documentation, you can submit a written statement explaining your income along with any supporting materials (bank statements, unemployment benefit letters, etc.).
Step 3: Complete the Confidential Statement of Financial Condition. This is Sutter's application form. Fill it out for all members of your household. List total household size and combined annual income.
Step 4: Submit your application. Mail your completed application and supporting documents to:
Sutter Shared Services Central Billing Office
Attn: Charity Care Team Member
P.O. Box 619010
Roseville, CA 95661
You may also submit in person at any Sutter Health facility's patient services desk.
Step 5: Follow up. Sutter is required to process your application and notify you in writing. If approved, any unpaid balance subject to charity care is written off. If you receive a partial discount, Sutter must provide a payment plan at 0% interest.
Step 6: Appeal if denied. If Sutter denies your application and you believe you qualify, you can request a formal review. California's HCAI also accepts complaints about Fair Pricing Act violations at hcai.ca.gov.
Documents Needed
- Two most recent pay stubs (or alternative income documentation)
- Most recent federal income tax return (Form 1040)
- Proof of household size (government ID, lease, benefit letters for household members)
- Copy of the Sutter Health bill or account number
- Insurance explanation of benefits (EOB) if you are insured and applying due to high out-of-pocket costs
- For self-employed: bank statements or profit/loss statement covering the last 3 months
Common Reasons Applications Get Denied
- Income documentation was missing or did not cover the required period
- The application listed fewer household members than the household actually contains (always include everyone in the home)
- The care was provided at a Sutter outpatient clinic or physician office rather than a hospital (these may fall under a different assistance program)
- The patient did not respond to Sutter's request for additional information within the required window
- The account had already been sent to a collections agency before the application was filed (still apply; California law limits collections actions during a pending application)
How the Fair Pricing Act Protects You From Aggressive Collections
California's 2025 AB 2297 changes reinforced existing protections around collections. Sutter Health is prohibited from:
- Garnishing wages for unpaid hospital bills
- Foreclosing on your home or placing a property lien (in most cases)
- Obtaining a bench warrant for nonpayment
- Reporting a hospital debt to a credit bureau before the financial assistance process is complete
These protections apply while your application is pending and, if approved, permanently discharge the covered debt. If you receive a collections notice from Sutter or a third-party collector before you have applied for financial assistance, you still have the right to apply. File the application and notify the collector in writing that a financial assistance review is pending. This does not erase the debt automatically but triggers California's protections during the review.
Sutter Health Hospitals Covered by This Policy
Sutter Health operates facilities throughout Northern and Central California. The financial assistance policy under California's Fair Pricing Act applies to all Sutter general acute care hospitals, including but not limited to:
- Alta Bates Summit Medical Center (Oakland and Berkeley)
- California Pacific Medical Center (San Francisco)
- Memorial Medical Center (Modesto)
- Mills-Peninsula Medical Center (Burlingame)
- Sutter Auburn Faith Hospital (Auburn)
- Sutter Davis Hospital (Davis)
- Sutter Maternity and Surgery Center (Santa Cruz)
- Sutter Medical Center, Sacramento
- Sutter Santa Rosa Regional Hospital
Sutter surgery centers and affiliated physician groups may have separate billing policies. When you call (855) 398-1633, confirm which entity billed you and which assistance program applies to that specific bill.
What to Do If Your Bill Looks Inflated Before You Apply
California law sets maximum prices that hospitals like Sutter can charge uninsured patients under the Fair Pricing Act. But even insured patients regularly receive bills with duplicate charges, unbundled procedures, or charges for services never received.
Upload your hospital bill to the free CoveredUSA Bill Analyzer to find errors, overcharges, and charity care options in 30 seconds. The tool compares each line item against Medicare reference rates, flags charges that are statistically anomalous, and estimates your potential savings before you negotiate or apply for assistance. This step takes less time than a phone call and can meaningfully change the number you bring into a charity care conversation.
Frequently Asked Questions
Does Sutter Health financial assistance cover emergency room visits?
Yes. California's Fair Pricing Act applies to both inpatient and emergency department hospital bills at Sutter facilities. Emergency physician fees billed separately (by the treating physician's group rather than the hospital) may require a separate application to that physician group, but the hospital portion of your ER bill is covered.
Can I apply for Sutter Health charity care if I have insurance?
Yes. Insured patients qualify if their total out-of-pocket medical costs over the past 12 months exceed 10% of annual household income and their income is at or below 400% FPL. Bring your explanation of benefits (EOB) showing what you owe after insurance when you apply.
Does Sutter Health check my savings account or investments?
As of January 1, 2025, under AB 2297, monetary assets (bank accounts, brokerage accounts, etc.) cannot be used to disqualify you. Sutter may consider HSA balances only when structuring a repayment plan, not to deny charity care.
How long does the Sutter Health financial assistance application take?
Processing times vary, but most applications receive a determination within 2 to 4 weeks of submitting complete documentation. During that time, California law prohibits collections activity on the account.
What if I missed the deadline to apply?
There is no deadline under California law. You can apply after receiving a bill, after receiving a collections notice, or years after the service date. The only practical limit is that Sutter may refer accounts to collections if they remain unresolved for an extended period, but an active application pauses that process.
What is the difference between charity care and a discount payment at Sutter Health?
Charity care means the balance is written off entirely (you pay nothing). A discount payment means you pay a reduced amount based on a sliding scale tied to your income and household size. Patients at or below 200% FPL in 2026 typically receive full charity care. Patients between 201% and 400% FPL receive a partial discount and an interest-free payment plan for the remaining balance.
Can Sutter Health bill me again after approving charity care?
No. Once Sutter approves charity care for a specific service, the covered balance is discharged. They cannot later restart collections on that same account. If a collection attempt continues after written approval, file a complaint with HCAI at hcai.ca.gov.
What if I need help with a Sutter bill and also need health coverage going forward?
Those are two separate issues. For the existing bill, apply through the process above. For getting insured going forward, California's Medi-Cal program covers adults earning up to 138% FPL with no premium, and Covered California marketplace plans offer subsidies up to 400% FPL. Check your eligibility at coveredusa.org to see which program fits your household.
