Hospital financial assistance and charity care
Most non-profit hospitals are legally required to have a financial assistance policy — and many patients never ask. If a hospital bill is unaffordable, apply in writing before paying, not after collections start.
The 501(r) rules (non-profit hospitals)
Non-profit hospitals must maintain a written financial assistance policy, publish a plain-language summary, and limit what they charge patients who qualify — often to no more than the amount paid by insured patients (the "amounts generally billed" limit). They must also tell you about the policy before and during collection efforts, and they generally cannot take extraordinary collection actions without first checking whether you qualify.
Who qualifies
Policies set income limits as a percentage of the Federal Poverty Level; many cover households up to 200–400% FPL, and some states and hospital systems go higher. Eligibility is usually based on household income and size, sometimes with an asset test. Each hospital's policy is different — read the policy document, not a verbal summary.
How to apply
- Ask the hospital's financial counselling or patient financial services department for the financial assistance policy (FAP), the plain-language summary and the application form.
- Request an itemised bill — not just the summary — and review it for errors.
- Submit the application with proof of income (pay stubs, tax return, benefits letters) and any other documents the policy requires. Keep copies and get a receipt or confirmation.
- Ask for a hold on the account while the application is reviewed.
- If denied, ask for the reason in writing and appeal; many denials are fixable (missing documents, wrong income period).
If you do not qualify — or the hospital is for-profit
Ask about interest-free payment plans, prompt-pay discounts (often 10–30% if paid quickly), a reduced self-pay rate, and whether the bill qualifies for state charity-care or Medicaid assistance. Compare the self-pay price with the amount insurers pay — the "gross charge" on the bill is rarely what anyone pays. Medical debt-collection rules vary by state; get advice before signing anything that admits liability.
Get help
State consumer-assistance offices, patient advocates, and non-profit medical-debt groups help with appeals, often for free. Apply for Medicaid and hospital charity care in parallel — help from one does not disqualify the other.
{faq([ ("Do hospitals have to offer financial assistance?", "Non-profit hospitals generally must have a written financial assistance policy with income-based " "discounts under IRS 501(r) rules. For-profit hospitals are not bound by those rules, but many still " "offer payment plans or discounts."), ("Can I apply for charity care after the bill is sent to collections?", "Often yes. The hospital must tell you about its policy during collections, and many allow " "applications later. Ask in writing and check the policy's deadline."), ("What is a prompt-pay discount?", "A reduction — often 10-30% — offered if a self-pay patient pays quickly or in full. It is separate " "from charity care and can sometimes be combined with a payment plan."), ])}Written and maintained by the US Hospitals data team · last reviewed 2026-10-24 · sources and methodology.