Adventist Health Ukiah Valley：经济援助与慈善医疗

Adventist Health Ukiah Valley 的政策内容

政策详情以英文原文引自医院自己的备案文件。

申请条件： 0-200% FPL: 100% discount. 201-300% FPL: 50-75% discount on the AGB rate. 301-400% FPL: 75-100% discount. Above 400% FPL: no discount under this policy, though insured patients with high medical costs (>10% of household income) may still qualify under a separate table.

需要提供：

• Recent pay stubs from within 6 months of first bill, OR
• Federal income tax return (Form 1040) for patient and spouse/domestic partner
• Self-declaration of income is accepted if the above are unavailable

Adventist Health Ukiah Valley 采用 Adventist Health 的经济援助政策，另有 23 家加州医院共用此政策。

信息来自医院自己的备案文件，最后核对日期为 2026年9月22日。医院可能会更改政策；以医院现行政策为准。