Patients who meet the established FAP criteria may be eligible for 50% to 100% reduction of their CHOC bill. Families that are verified at 200% or less of the Federal Poverty Limits (FPL) will receive 100% reduction of their CHOC bill.
The most recently published Federal Poverty Limits will be used in the assessment of a family qualifying for the CHOC Financial Assistance Plan. Financial documentation, such as current tax return records, income verification, as well as bank statements may be required to determine eligibility.
Families may obtain a copy of the CHOC FAP application in English or Spanish below or by calling the CHOC Family Payment Center at 714-509‐8600. A Family Payment Center representative may provide assistance in understanding the process on how to complete the FAP application.