Low-Cost Health Care in Los Angeles: LA County's Ability to Pay Program, County Clinics and Sliding-Fee Health Centers

In Los Angeles, the biggest discount on health care comes from LA County Health Services, the county’s public hospital and clinic system. Its Ability to Pay (ATP) program makes care free for county residents with income at or under 200% of the federal poverty level, and cheaper on a sliding scale above that [1]. The county says no one will be denied services because they can’t pay [1].

This guide covers how to get care and what it costs. It isn’t medical advice.

The Ability to Pay program

ATP is LA County Health Services’ financial assistance program for Los Angeles County residents [1]:

• At or under 200% of the federal poverty level: no cost.
• Over 200%: a reduced cost on a sliding scale based on family size and income. The county posts the scale on its Patient Financial Services page.

How to apply

Patient Financial Services (PFS) staff help you apply for ATP or Medi-Cal, answer billing questions and take payments. Most PFS locations are open Monday through Friday, 8 a.m. to 4 p.m. [1]. The county also posts the ATP policies, applications and brochures in many languages on the same page [1].

If you might qualify for Medi-Cal, PFS can help, or you can apply yourself at BenefitsCal.com or by calling the Department of Public Social Services at (866) 613-3777 [1].

Getting care in the county system

LA County Health Services starts you with a primary care clinic it calls a medical home, with adult, pediatric and family medicine clinics plus clinics for women, older adults, people with HIV and people with disabilities [2]. Care is available to uninsured county residents regardless of ability to pay, and to people with Medi-Cal, Medicare or CHIP [2]. It also offers interpreters and help getting a ride to appointments [2].

To find a medical home, use the search on the county’s Get Care page or call 844-804-0055 [2].

Nurse advice line. For patients of county clinics and for uninsured LA County residents, nurses answer at 844-804-0055, Option 2, from 7 a.m. to 10 p.m., seven days a week [4]. County patients can also send an eVisit through the LA Health Portal without an appointment [6].

Public health centers: shots and testing

The county Department of Public Health runs 14 public health centers, plus a satellite site on Skid Row, offering immunizations and testing for tuberculosis and sexually transmitted infections [7]. Its Community Health Services page lists an immunization fee of $15 per child or adult, or $30 for a family with two or more children, and says no child will be denied vaccines because the family can’t pay [7]. If you have insurance that covers shots, the county asks you to use your regular provider [7].

Sliding-fee community health centers

Federally funded community health centers are spread across Los Angeles. Find the ones near you with HRSA’s Find a Health Center tool [8]. Under federal rules for these centers [9]:

• Families at or below the poverty guidelines get a full discount, though a nominal fee may be charged.
• There’s no required discount above twice the poverty guidelines.
• No one may be denied service for inability to pay.

Ask each center for its own fee schedule and what proof of income it wants.

If a hospital won’t help with your bill

California’s Hospital Bill Complaint Program reviews hospital decisions on whether you qualify for help paying a hospital bill. If you think you were wrongly denied financial assistance, you can file a complaint at hospitalbillcomplaint.hcai.ca.gov [1].

Which door to try first

• LA County resident at or under 200% of poverty, uninsured: a county medical home with the ATP program [1][2].
• Might qualify for Medi-Cal: apply through BenefitsCal or DPSS [1].
• Need shots or STI testing: a county public health center [7].
• Want a clinic close to home: a community health center from HRSA’s tool [8].