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Hospital financial assistance (charity care)

Many hospitals will reduce or forgive a bill for people who can't afford it. Nonprofit hospitals are required to have a program. Here is how it works, who may qualify, and how to ask.

Updated October 2026

What hospital financial assistance is

Financial assistance, often called charity care, is a hospital program that reduces or forgives bills for patients who can't afford them. Depending on your income and the hospital's policy, it can mean free care, a discount, or a payment plan. It applies to the hospital's own bills; doctors who bill separately may have their own programs, so ask them too.

What nonprofit hospitals must do

Most hospitals in the United States are nonprofit, and in exchange for their tax exemption, IRS rule 501(r) requires them to:

• Have a written financial assistance policy that says who qualifies, what help is available and how to apply.
• Make it widely available, with a plain-language summary and the application on their website, in the hospital and on request.
• Limit charges for eligible patients. For emergency and other medically necessary care, a patient who qualifies can't be charged more than the "amounts generally billed" to people with insurance.
• Wait before extraordinary collection actions. They must wait at least 120 days after the first bill they send after you leave before steps like reporting you to a credit bureau or suing, and they must make reasonable efforts to find out whether you qualify first.
• Accept late applications. They must accept applications for at least 240 days after that first bill.

Some for-profit hospitals have assistance programs too. There is no harm in asking any hospital.

Who may qualify

Each hospital sets its own rules, usually by comparing your household income with the federal poverty guidelines. For 2026, in the 48 contiguous states and Washington, D.C., the guidelines are $15,960 for one person, plus $5,680 for each additional person. Alaska and Hawaii are higher.

• 1 person: $15,960
• 2 people: $21,640
• 3 people: $27,320
• 4 people: $33,000
• 5 people: $38,680

Many hospitals give free care below about 200% of these amounts, and discounts up to about 300% or 400%. For a family of four, 200% is $66,000 a year and 400% is $132,000. Those are common ranges, not rules: some hospitals are more generous, some less, and some also consider very large bills or medical debt compared with income. The only way to know is to read the policy and apply.

How to apply

1. Ask for the policy and the application. Call the billing office or look on the hospital's website for "financial assistance" or "charity care".
2. Ask for a billing hold while your application is reviewed, so the account isn't sent to collections.
3. Gather proof of income, usually recent pay stubs, a tax return, or a letter about benefits. Follow the list in the application.
4. Send the application with a short cover letter, by tracked mail or the patient portal, and keep copies.
5. Follow up if you don't hear back within 30 days, and ask for the decision in writing.

Apply even if you already paid part of the bill or set up a payment plan. If you qualify, ask whether the discount applies to what you already paid.

Check the bill too

Financial assistance and billing mistakes are separate questions. A bill can be wrong and also qualify for a discount. It is worth checking the charges line by line before you apply; see how to dispute a medical bill and how to get an itemized bill. If you were billed by an out-of-network doctor, read about the No Surprises Act.

Common questions

Do nonprofit hospitals have to offer financial assistance?

Yes. Under IRS rule 501(r), tax-exempt hospitals must have a written financial assistance policy, publish it with a plain-language summary and an application, and limit what eligible patients are charged for emergency and other medically necessary care.

Who qualifies for hospital financial assistance?

Each hospital sets its own rules, usually based on household income compared with the federal poverty guidelines. Many hospitals give free or discounted care up to about 200% to 400% of the guidelines. The only way to know is to ask for the policy and apply.

Can I apply after I get the bill?

Yes. Nonprofit hospitals must accept applications for at least 240 days after the first bill they send after you leave the hospital. Apply as early as you can, and ask for a billing hold while your application is reviewed.

What are the 2026 federal poverty guidelines?

For the 48 contiguous states and Washington, D.C., $15,960 for one person, plus $5,680 for each additional person. For a household of four, that is $33,000. Alaska and Hawaii have higher guidelines.

Sources

• IRS: Financial assistance policy and emergency medical care policy, section 501(r)(4)
• IRS: Limitation on charges, section 501(r)(5)
• IRS: Billing and collections, section 501(r)(6)
• HHS ASPE: Poverty guidelines

Billcheck is a medical bill review tool, not a law firm. This guide is general information, not legal or medical advice. Rules vary by state and by health plan.