Quick answer
Under section 501(r) of the tax code, nonprofit hospitals must have a written financial assistance policy for emergency and medically necessary care, publish it with a plain-language summary and application, and note it on bills. Search the hospital's name plus "financial assistance," or ask billing. Apply even if you have insurance or the bill is in collections. Nonprofit hospitals must accept applications for at least 240 days after the first bill after discharge.
Who qualifies
Each hospital sets its own income limits, usually as a percentage of the federal poverty guidelines, and whether help is free or discounted. Some states require more generous charity care than federal rules. Underinsured patients with big deductibles often qualify for a discount.
How to apply
- Find the policy. On the hospital's website, or ask the billing office for the policy, the summary and the application. Paper copies must be free.
- Gather proof. Recent pay stubs or tax return, benefit letters, household size, and the bills.
- Apply in writing. Keep a copy and note the date you sent it.
- Tell collectors. If a bill is with a collector, tell them you applied.
- Ask for the decision in writing. If approved, ask for a corrected bill and refunds of any amount you paid above it.
What the rules protect
Nonprofit hospitals must make reasonable efforts to find out whether you qualify before taking extraordinary collection actions, such as reporting to credit bureaus or a lawsuit. They also cannot charge people who qualify more than the amounts generally billed to insured patients for emergency or needed care.
Not a hospital bill?
Federally funded health centers charge on a sliding fee scale based on income. HRSA's finder lists them by ZIP code.
Common questions
Does charity care apply if I have insurance?
It can. Many policies cover the part you owe after insurance, such as deductibles and coinsurance, if your income qualifies.
What if the hospital is for-profit?
Federal 501(r) rules apply to nonprofit hospitals, but many for-profit hospitals have their own assistance programs and some states require them. Ask.
What if I am denied?
Ask for the reason in writing, check whether your income was counted correctly, and ask for a discount or interest-free plan. Your state's consumer assistance program can help with disputes.
Where these facts come from
- IRS: hospital financial assistance policies, section 501(r)
- IRS: hospital billing and collections under section 501(r)(6)
- CFPB: is there financial help for my medical bills?
- CMS: apply for medical bill financial assistance
- HRSA: find a health center with sliding fees
Sources checked October 10, 2026. Programs and rules change; confirm details with the agency or company before you act.
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