How to get help applying for healthcare coverage and financial assistance
Step 1: Complete a financial assistance application
Applications must be complete to be processed, and all the required documents must be complete. Applications that are not finished and/or do not have all the documents will not be processed.
Step 2: Provide all required documents
You will need to provide copies of the documents in the Document Checklist with your application. Documents include:
- Proof of identity
- Proof of Santa Clara County residency
- Proof of income
When you have all your documents, attach them to your completed application and turn them in.
Step 3: Get all information to the Patient Access Department
Completed applications with all the required documents can be faxed to (408) 494-7848, delivered in person to the CSCHS Patient Access Department (770 S. Bascom Avenue San José, CA 95128), or scanned and e-mailed to [email protected]. Should you wish to e-mail CSCHS, we recommend that you encrypt your message to protect the privacy and security of your personal documents. They can also be delivered to Patient Access Department, 770 S Bascom Ave, San Jose Ca.
The information will be reviewed according to the rules for each program or agency. The staff uses these rules to determine if you are eligible for a state program, a county program, as discount or full financial assistance.