1. Healthy San Francisco
  2. For Participants

Fees

Protect Yourself From Scams

Scammers will try to get your money or private information. Be alert and protect yourself from being scammed, and know the following:

  • Healthy San Francisco program (HSF) will never call and ask you for money. If you get any messages like this, call Healthy San Francisco Customer Service to report it: 1(415) 615-4555.

  • For participant fees, Healthy San Francisco accepts:

    • Personal checks
    • Money orders
    • Online payments made through Heathy San Francisco’s payment portal
      Please click here for instructions to pay by check.
  • Healthy San Francisco doesn’t accept payments using:

    • Venmo
    • Zelle
    • Other forms of payment

Have questions or concerns about your participant fee or how to pay?

Please call HSF Customer Service at 1(415) 615-4555, Monday through Friday, 8:00am to 5:00pm.

Participant Fees

You may have to pay a fee for your health coverage. The HSF participant fee is based on a “sliding scale.” This means that the cost of the participant fee is based on your income. In other words, if you earn less, you will pay less. If you earn more, you will pay more.

Use the chart below to see whether you may need to pay a participant fee. Your exact cost, if any, will be calculated for you by a Certified Application Assistor when you fill out your application.

Participant’s Monthly Family Income
Household Size 0% – 100% of FPL 101% – 200% of FPL 201% – 300% of FPL 301% – 400% of FPL 401% – 500% of FPL
1 $0 – $1,330 $1,331 – $2,660 $2,661 – $3,990 $3,991 – $5,320 $5,321 – $6,650
2 $0 – $1,804 $1,805 – $3,608 $3,609 – $5,410 $5,411 – $7,216 $7,217 – $9,017
3 $0 – $2,277 $2,278 – $4,554 $4,555 – $6,830 $6,831 – $9,108 $9,109 – $11,384
4 $0 – $2,750 $2,751 – $5,500 $5,501 – $8,250 $8,251 – $11,000 $11,001 – $13,750
5 $0 – $3,224 $3,225 – $6,448 $6,449 – $9,670 $9,671 – $12,896 $12,897 – $16,117
6 $0 – $3,697 $3,698 – $7,394 $7,395 – $11,090 $11,091 – $14,788 $14,789 – $18,484
7 $0 – $4,170 $4,171 – $8,340 $8,341 – $12,510 $12,511 – $16,680 $16,681 – $20,850
8 $0 – $4,644 $4,645 – $9,288 $9,289 – $13,930 $13,931 – $18,576 $18,577 – $23,217
Quarterly Participant Fees (Paid Four Times a Year per Individual)
Quarterly Participant Fee
Per Person		 $0 $60 $150 $300 $450

(Based on March 2026 FPL, subject to change)

*FPL is the Federal Poverty Level

Once you join HSF, you will be able to use all our services. In some cases, you may be able to get care before paying your first participant fee.

Call HSF Customer Service if your income or household size changes after joining HSF. This new information may raise or lower your Participation Fees. For example, your participation fee amount may go down if you have a new, lower income. Your fee amount might also go down if there are more people living in your household.

Point of Service (POS) Fees

On top of the participant fee, you may pay a Point of Service (POS) fee. A POS fee is billed to your clinic each time you get care. For example, there will be a fee each time you visit a doctor, emergency room, or pick up a prescription.

The POS fee amount depends on:

  • Your Medical Home
  • Your household income
    • If your income is below a certain amount, you will not pay a POS fee for most services

SF Department of Public Health (DPH) POS Fees

Medical Homes working with the San Francisco Department of Public Health (DPH) will collect POS fees from Healthy San Francisco Participants according to the following schedule:

Household Size0% – 100% of FPL101%-200% FPL201%-500% FPL
Primary $0 $10 $10
Urgent $0 $20 $20
Ancil / Rad / PT / OT $0 $20 $20
Specialty $0 $20 $20
Pharmacy $0 $5 / $25 $5 / $25
ER $0 $25* $25*
Same Day Surgery $0 $100 $100
Inpatient $0 $200 / admit $200 / admit
Behavioral Health UMDAP1 UMDAP1 UMDAP1

*If non-emergency and non-admission at SFGH.
**Please check with your clinic at the time of service, as prices may change based on the care you get. Fees are subject to change. There are no fees for unhoused clients.

POS Fees at Other HSF Medical Homes

POS fees vary by clinic. If your Medical Home is tied to any of the clinics below, please call your Medical Home directly to learn the schedule of their POS fees:

  • SF Community Clinic Consortium (SFCCC)
  • Kaiser Permanente
  • Sister Mary Phillippa Health Center

1Behavioral health (mental health care and substance use services) Point of Service fees are based on Uniform Methods of Determining Ability to Pay (UMDAP) outlined by the State of California.