Every Woman Counts (EWC) Program

The Department of Health Care Services (DHCS), Every Woman Counts (EWC) Program, provides eligible women with free breast and cervical cancer screening services, such as mammograms, clinical breast exams, Pap tests, and Human Papillomavirus (HPV) tests (in combination with a Pap test). EWC also assists eligible women with enrollment into the Breast and Cervical Cancer Treatment Program (BCCTP).

Eligibility Criteria:

In order for women to be eligible for free EWC services, they must:

Live in California,
Have no or limited health insurance,
Have health insurance with a co-payment or deductible they cannot afford,
Not be eligible for MC,
Have income up to 200 percent of the federal poverty level,
Be at least 40 years of age for a clinical breast exam and a mammogram,
Be at least 21 years of age for a Pap test.

EWs must share the EWC Program Brochure with women found ineligible for MC, Covered California health plans, or other county medical coverage services.

Note: The EWC Brochure is available for printing on the DHCS website.

Women are able to call an automated referral line at (800) 511-2300 or use an Online Provider Locator to find up to ten doctors or clinics in their area that provide these services. Both the automated referral line and the Online Provider Locator are available
twenty-four hours a day, seven days a week.

Health Care Coverage Assistance Program

Santa Clara Valley Health Hospital System (SCVHHS) provides several medical financial assistance programs and services to help Santa Clara County residents pay for the hospital/medical costs incurred with SCVHHS. Among the programs and services provided are:

Ability to Pay Determination (APD)
Discount Program
Waiver Program
Inpatient Financial Services

If no insurance coverage is available, a financial counselor may assist with an application for MC or other financial assistance program. The Financial Counselor will determine the program to which eligible based on the information provided on the Financial Assistance Application (FAA).

Emergency Services

Every person who needs emergency services will receive them regardless of their ability to pay; however, non-emergency services must be paid prior to receiving them if the patient is not a Santa Clara County resident. As part of the screening process, the patient will be asked about any active insurance coverage. Any co-pays will be collected.

Application

Financial Assistance Applications may be obtained in person at:

SCVHHS

Patient Access Department

770 South Bascom Avenue, Door A San Jose, CA 95128

Hours: M - F from 8 AM to 4 PM

Phone: 1-866-967-4677

Applicants may obtain the FAA on-line at and e-mail the application to HHSVCApp@hs.sccgov.org or fax to (408) 494-7848.

Verifications

The following verifications are required to process the Financial Assistance Application and apply to all programs:

Proof of residency
- Rental/Lease contract
- Mortgage statement
- Utility bill
Proof of Identity
- Drivers License
- Passport
- Government issued ID
- Work or school ID
Proof of Income (Provide all that apply)
- Check stubs (all stubs within 45 days from date of application)
- Tax return (current tax year)
- Award letter (SSA, Unemployment, Disability, Worker’s Comp)
- Cash income statements (including tips)
- Military benefits statement
- Rental income receipts

Additional verifications may be required based on a variety of factors.

Ability to Pay Determination Program

The APD program is designed to bill poor and low income patients according to their ability to pay. APD has a co-pay that varies from $50 - $300 which is required prior to receiving services.

Who May Qualify for APD

An individual may quality for APD if all of the following conditions are met:

Received medical care, treatment or services at or arranged through VMC; and
Is a resident of Santa Clara County; and
NOT covered by or eligible for any other medical assistance program or other health insurance; and
Income and family size are within APD guidelines.

APD Period and Re-evaluation

APD Determination will cover six calendar months.

Determination will be re-evaluated upon:
Any inpatient admission during the six month period.
Expiration of the six month period and a new request is submitted.
Request by the individual due to income or family size change.

Valley Care

Valley Care was a publicly funded health care program that provided individuals living in Santa Clara County basic health coverage. Valley Care was Santa Clara County’s Low Income Health Program (LIHP). The LIHP program was discontinued in 2014.

Discount Program

The Discount Program is for individuals who do not qualify for APD. If they meet all eligibility criteria, their charges can be discounted by a percentage.

Waiver Program

The Waiver Program is for individuals who are not Santa Clara County residents. If they meet all eligibility criteria, a part of the cost may be waived.

Inpatient Financial Services

(informational flyer in ch 41 folder)

Inpatient Financial Services is application assistance provided by Financial Counselors to patients in the hospital who help them apply for MC, APD, or other financial programs to help pay for the hospital costs.