California: Medical Baseline Allowance
The Medical Baseline Allowance is run by the large investor-owned utilities under California Public Utilities Commission oversight. Eligibility depends on a medical need, not income. A customer or a full-time resident can qualify if they rely on life support equipment, have a life-threatening illness or a compromised immune system, or have a condition for which additional heating or cooling is medically necessary.
The program provides additional units of energy at the lowest rate, so a household is not charged higher tier prices for medically necessary use, and it provides prior notice of planned power outages.
- Find your utility. The CPUC fact sheet lists PG&E, SCE and SDG&E for electric service.
- Get the application from the utility online, by mail or by phone.
- Have a qualified medical practitioner complete and sign it.
- Allow time for processing. Utilities describe processing in weeks, so check yours.
Source: CPUC medical baseline fact sheet, 2021, and utility program pages, read October 10, 2026. Phone numbers and forms change, so use the current ones on your utility's Medical Baseline page.
Texas: critical care and chronic condition designations
| Designation | Who qualifies | How long it lasts |
|---|---|---|
| Critical care residential customer | A person who lives in the home permanently and whom a physician diagnoses as dependent on an electric-powered medical device to sustain life. | Two years. |
| Chronic condition residential customer | A person who lives in the home permanently and whom a physician diagnoses with a serious medical condition that requires an electric-powered medical device or electric heating or cooling to prevent serious deterioration. | The shorter of one year or until the person leaves the home for a lifelong condition, otherwise 90 days. |
A physician submits the commission-approved form to the delivery company, directly or through the retail provider, which must forward it within two business days. The delivery company may not challenge the physician's determination, though it may verify the physician's identity and signature. A temporary designation can apply while a form is processed.
Critical care customers get protection against suspension or disconnection under the delivery company's tariff, along with interruption notifications. Chronic condition customers get interruption notifications and certain protections in the disconnection rule. The rule states that a designation does not guarantee uninterrupted service and does not relieve a customer of the obligation to pay.
Source: Texas rule text read on October 10, 2026. Rules change, and this is one state's rule used as a worked example. Your state's rules differ, so confirm with your utility and your state commission.
Elsewhere in the country
Many states let a doctor's certificate delay a shutoff for a set number of days, and many utilities keep a list of customers who rely on medical equipment so they can give advance notice of planned outages. The names and rules differ. Call your utility's customer service line and ask what it offers for a customer who relies on medical equipment, and ask your state commission what the law requires.
Plan for an outage anyway
- Ask your doctor and the equipment supplier about a backup power plan, such as a battery that runs the device for a set number of hours.
- Keep the utility's outage number and your account number where you can find them fast.
- Tell your local emergency services or fire department if you rely on powered equipment, if your area has a registry.
- Sign up for outage alerts from the company that owns the lines.
Help with the cost
These programs lower or protect, and bill help pays part of what you owe. Apply for LIHEAP if you may qualify, and ask the utility about payment plans. A medical designation in Texas also works with the rules on shutoff protection.
Sources and further reading
Frequently asked questions
What is medical baseline?
A California program in which eligible customers get additional energy at the lowest rate and advance notice of planned outages. It is based on medical need, not income.
Does a medical designation stop a shutoff?
It can delay one. In Texas a critical care designation protects against disconnection for set periods, but the rule says a designation does not guarantee uninterrupted power or relieve a customer of paying the bill.
Who signs the application?
A physician or other qualified medical practitioner. In Texas the form goes to the delivery company, and in California it goes to your utility.
What if I do not live in California or Texas?
Ask your utility and your state commission. Many have a medical certificate process and a list of customers who rely on medical equipment.