DFCS Online Policies & Procedures

  DFCS Online Policies & Procedures

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Handbook 15-5: Health Care
15-5  Low Cost Health Coverage Programs at Valley Medical Center (VMC)
Health Care
15-5  Low Cost Health Coverage Programs at Valley Medical Center (VMC)
Reference Points
Overview
Ability to Pay Program
Valley Care Program
Emergency Services


Reference Points
Effective Date: 7/1/09
Last Updated: 7/23/09


Overview   Santa Clara Valley Medical Center (SCVMC or, commonly, VMC) provides medical care to the residents of Santa Clara County, regardless of their ability to pay.  Two financial programs offered by VMC are the Ability to Pay program and the Valley Care program.
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Ability to Pay Program  

Valley Medical Center's (VMC's) Ability to Pay Program (APD) assists those who receive services at VMC but do not have insurance or an affiliation with another health care program.  Those who qualify for APD will have a co-pay and not all services are covered under APD. 

  VMC Ability to Pay Program

Qualifying for APD

In order to qualify for APD, an individual must meet income, age, and residency requirements.  The individual must:

  • Be age 21 or older
  • Be a Santa Clara County resident
    • Undocumented resident with five years of residence in Santa Clara County qualify. 
    • Individuals on VISAS do not qualify but may be eligible for discounted charges.
  • Not be eligible for programs such as Medi-Cal or Medicare
  • Not have other health insurance
  • Not expect payment to be made on behalf of the individual by any other person or company
  • Meet low-income criteria

 

Services

APD covers any service ordered by a VMC physician.  This may include patient visits, lab tests, radiology screenings or treatment, therapy, and health education services, if needed.  Coverage for dental care is on an emergency-only basis.

 

Applying for APD

A person may apply for APD in a variety of ways:

  • VMC's Emergency Department and Admitting Department have clerical staff and/or Financial Counselors who can assist patients in applying for the APD program.
    • Emergency Department

    751 South Bascom Ave.

    San Jose, CA  95128

    • Admitting Department

    751 South Bascom Ave.

    San Jose, CA  95128

    (408) 885-6600


    • Patients may ask about the program when calling for an appointment or at the time they are seen at the hospital or VMC clinics.
  • Call (888) 334-1000 to be screened for APD.
    • Customer Service at Patient Business Services can also assist in the APD application process.
      • Patient Business Services Dedicated Customer Service Unit.

      2325 Enborg Lane

      San Jose, CA  95128

      (408) 885-7470

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Valley Care  

The Valley Care program offered through VMC differs from the Ability to Pay program.  With the Valley Care program, the individual pays lower co-payments, there is an assignment of a primary care provider, and there are additional benefits such as member services. 

Valley Care Program

Qualifying for Valley Care

Valley Care is available to individuals who:

  • Are between the ages of 19-64 years of age
  • Live in Santa Clara county
  • Have not had any type of health insurance in the previous 90 days
  • Are not eligible for Medi-Cal or Medicare
  • Are United States citizens or have been Lawful Permanent Residents for 5 years or more
  • Have a family income less than 200% of the Federal Poverty Level



Services

Individuals who qualify for the Valley Care program:

  • Have access to services such as emergency dental, health education, outpatient visits, ambulatory surgery, required ER visits, and inpatient hospitalization.
  • Receive coverage for one full year before they have to renew
  • Have access to a wide variety of doctors and service locations
  • Have low co-payments that are based on income



Applying for Valley Care

To apply for Valley Care, a person may contact a Financial Counselor at Valley Care at (888) 363-3394 to determine if they are eligible.

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Emergency Situations   At Valley Medical Center, every person who needs emergency services will receive the services regardless of the person's ability to pay; however, non-emergency services must be paid for prior to receiving the service if the person is not a resident of Santa Clara County.
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