Hospital Financial Assistance: Eligibility and How to Apply

Nonprofit (501(c)(3)) hospitals are legally required to have a written financial assistance policy that says who qualifies for free or discounted care, and to widely publicize it. The help it describes is called "charity care" or "financial assistance."

Under IRS Section 501(r)(4), the written policy must state the eligibility criteria, whether assistance means free or discounted care, the basis for calculating what patients are charged, and how to apply. Each hospital sets its own criteria, so read the policy for the hospital that billed you.

Who Qualifies for Charity Care?

Eligibility is set by each hospital's policy, usually as a percentage of the federal poverty level (FPL), and thresholds vary. For example, a policy might offer:

• 100% charity care (free): Household income below 200% of Federal Poverty Level (FPL)

• Partial charity care (reduced bills): Income between 200-400% of FPL

• Some hospitals: Extend assistance up to 400-500% of FPL

2026 Federal Poverty Level Guidelines

(48 contiguous states and DC; Alaska and Hawaii have higher guidelines)

• 1 person: $15,960/year (200% = $31,920, 400% = $63,840)

• 2 people: $21,640/year (200% = $43,280, 400% = $86,560)

• 4 people: $33,000/year (200% = $66,000, 400% = $132,000)

How to Apply for Charity Care

1. Find the application: Search "[Hospital Name] financial assistance application" or call the billing department. Hospitals are required to make applications available.

2. Gather documentation: You'll typically need:

   • Recent pay stubs or tax return

   • Proof of household size

   • Bank statements (sometimes)

   • The medical bills you need help with

3. Submit your application: Some hospitals allow online submission; others require mail or in-person delivery.

4. Follow up: Call to confirm receipt and ask when to expect a written decision. The hospital must notify you in writing whether you qualify.

Important Tips

• Apply even if you think you won't qualify: Policies are often broader than people expect, and some consider medical debt and expenses in their calculations.

• Apply early, and know the federal timeline: At a nonprofit hospital, the application period runs at least 240 days from the first post-discharge bill. Before starting extraordinary collection actions (ECAs), the hospital generally must wait at least 120 days from that bill and give you written notice with a plain-language policy summary at least 30 days beforehand; regulatory exceptions can apply. A complete application received during the application period suspends ECAs until the hospital makes and sends a written eligibility determination. If an application is incomplete, the hospital must pause ECAs, tell you in writing what is missing, and give you a reasonable chance to complete it.

• You can apply retroactively: Some hospitals will retroactively apply charity care to bills from the past year or more.

• Don't ignore the bill while waiting: Ask billing to note that your application is pending. A complete application submitted during the application period suspends ECAs until a written eligibility determination; for an incomplete application, the hospital must identify what is missing in writing and allow a reasonable completion period before resuming ECAs.

What If You're Denied?

If your initial application is denied:

• Ask why and what additional documentation might help

• Ask whether the hospital's policy has an appeal process, and if it does, appeal in writing

• Contact the hospital's patient advocate

• Ask about payment plans or other discounts

Finding Hospital Financial Assistance Policies

Under IRS Section 501(r)(4), nonprofit hospitals must widely publicize their policy, which includes:

• Posting the policy, application, and a plain-language summary on their website

• Including a notice about the policy on billing statements and discharge materials

• Offering paper copies in public areas, including the emergency room and admissions

Use FairVisitHealth to find links to major hospitals' financial assistance applications in your area.

Sources

• HHS Office of the Assistant Secretary for Planning and Evaluation, Poverty Guidelines (2026 figures above)

• 26 CFR 1.501(r)-4, Financial assistance policy (contents of the policy and how it must be publicized)

• 26 CFR 1.501(r)-6, Billing and collection (240-day application period, 120-day and 30-day notice rules, suspension of collections)

• IRS, Billing and collections, Section 501(r)(6)