Qualifications for Government Programs

Do I qualify for a government sponsored coverage program?

The Eligibility Services Department staff consists of eight MediCal Liaisons, with two stationed in the Emergency Room Department and three DPSS (Department of Public Social Services) workers. Collaboratively the hospital staff and DPSS workers strive to make the MediCal application process a timely and seamless process. All hospital staff have gone through a training program provided by Healthcare Association of Southern California and DPSS to receive certification as MediCal Application Assistors. The DPSS workers are stationed in the department to process your MediCal case and allow staff to track your case from start to finish.

We strive to keep current and updated information on government and county healthcare programs, so that in the event you do not qualify for MediCal, we can refer you to other programs to meet your healthcare needs. Pomona Valley Hospital Medical Center is proud to be one of two hospitals within Los Angeles County that has MediCal Application Assistors. Whether you have an account with the hospital or if you just need to apply for coverage, we are here to assist you.

We complete applications for the following programs:

  • MediCal
  • Healthy Families
  • PCIP (Pre-Existing Condition Insurance Plan)

If you meet the following criteria you may qualify for MediCal:

o   65 or older

o   Blind

o   Disabled

o   Under 21

o   Pregnant

o   On refugee status for a limited time, depending how long you have been in the United States

o   A parent or caretaker relative or a child under 21 if:

    -The child's parent is deceased or doesn't live with the child, or the child's parent is incapacitated, or the child's parent is under employed or unemployed

o   Have been screened for breast and/or cervical cancer (Breast and Cervical Cancer Treatment Program)


When you apply for benefits, you will need to bring several important documents. Different programs may have different requirements.


For additional information please call:
Family Health Center
Eligibility Services Department    
1770 Orange Grove Ave. Suite 233 Pomona, CA
(909) 469-9441
Para informacion en Espanol
(909) 469-9442
8:00am – 4:00pm


To view the required documentation, please click on the PDF below.

English Form

Spanish Form

Pomona Valley Hospital Medical Center - 1798 N. Garey Avenue - Pomona, CA 91767 - (909) 865-9500 - Contact Us
For AssociatesPVHMC SITE MAP — Copyright © 2013, Pomona Valley Hospital Medical Center. All Rights Reserved. — Notice of Privacy Practices