Hospital financial assistance (charity care): who qualifies and how to apply

Even when every charge on a bill is correct, you may not have to pay all of it. Most hospitals have a financial assistance program, and many people who qualify never apply.

Most U.S. hospitals are nonprofits. To keep their tax-exempt status, federal rules (section 501(r) of the tax code) require them to:

• Have a written financial assistance policy and make it easy to find, including a plain-language summary
• Limit what they charge eligible patients for emergency and medically necessary care to the amounts generally billed to insured patients
• Make reasonable efforts to see whether you qualify before taking serious collection actions, such as reporting to credit bureaus or suing
• Accept applications for at least 240 days after the first bill sent after you leave the hospital

Several states add their own requirements, sometimes covering for-profit hospitals too.

Each hospital sets its own income limits, often as a percentage of the federal poverty level. Some forgive the whole bill below one level and give a discount on a sliding scale above it. Having insurance doesn't automatically disqualify you; many policies also cover large out-of-pocket balances.

1. 1Search for "[hospital name] financial assistance policy" or ask billing for the application.
2. 2Gather proof of income (pay stubs, tax return or benefit letters) and household size.
3. 3Submit the application and ask billing to hold the account while it's reviewed.
4. 4Ask for the decision in writing. If you're approved, ask whether it applies to other open accounts too.