Hospital Charity Care:
Get Free or Reduced Medical Care
Nonprofit hospitals — about 58% of U.S. community hospitals — are required by federal law to maintain a written Financial Assistance Policy and to consider your application against it. Many forgive bills entirely. Here's how to find out whether you qualify and apply successfully.
Have a bill? Upload it and get the audit in about 30 seconds.
Audit my billWhat is Hospital Charity Care?
Charity care (also called "financial assistance") is free or discounted medical care that hospitals provide to patients who qualify under their own written policy. Under IRS Section 501(r), nonprofit hospitals — about 58% of U.S. community hospitals, or 2,984 of 5,121 (AHA Fast Facts on U.S. Hospitals, 2026) — are legally required to:
- Establish a written financial assistance policy (FAP)
- Make the policy widely available to patients
- Not charge eligible patients more than the amounts generally billed to insured patients
- Not pursue aggressive collection actions against eligible patients
What the law does not do is set the income cutoff. 501(r) mandates the policy, not free care at any particular income — each hospital writes its own thresholds, and they are usually more generous than patients expect. For-profit and government hospitals are not covered by 501(r) at all, though many run assistance programs voluntarily and a handful of states (including California, Washington, Illinois, New Jersey and New York) require assistance from every hospital.
Key Insight
Many patients who qualify for charity care never apply because they don't know it exists. Hospitals aren't always proactive about telling you—you often have to ask.
Income Guidelines for Charity Care (2026)
Most hospital charity care programs use Federal Poverty Level (FPL) as the basis for eligibility. Here are typical thresholds:
| FPL % | Single Income | Family of 4 |
|---|---|---|
| 100% | $15,960 | $33,000 |
| 200% | $31,920 | $66,000 |
| 300% | $47,880 | $99,000 |
| 400% | $63,840 | $132,000 |
Note: These are the federal poverty thresholds hospitals commonly index their policies to. Each hospital sets its own cutoff and its own discount, and many extend eligibility higher for large bills relative to income (called "medical hardship" provisions). Read the hospital's own Financial Assistance Policy, then apply.
How to Apply for Charity Care
Step 1: Get the Application
Call the hospital billing department and ask for a "financial assistance application" or "charity care form."You can also find these on most hospital websites under "Billing" or "Financial Services."
Step 2: Gather Documentation
You'll typically need: proof of income (pay stubs, tax returns), bank statements, list of monthly expenses, proof of residence, and your medical bills.
Step 3: Complete the Application
Fill out every section completely. Incomplete applications are the #1 reason for denials. Include a brief explanation letter describing your financial situation.
Step 4: Submit and Follow Up
Submit via certified mail or in person. Keep copies of everything. The hospital must respond within 30-60 days. Follow up if you don't hear back.
What to Say When Calling
Opening Script:
"Hi, I'm calling about a bill I received. I'm experiencing financial hardship and would like to apply for your financial assistance program. Can you send me the application and tell me what documentation I'll need?"
If they don't mention it:
"I understand [HOSPITAL NAME] is a nonprofit hospital. Under IRS Section 501(r), you're required to have a financial assistance policy. Can you tell me how to apply?"
If initially denied:
"I'd like to appeal this decision. Can you tell me the appeals process? I have additional documentation showing my medical debt exceeds [X]% of my annual income."
Frequently Asked Questions
What is hospital charity care?
Charity care is free or discounted medical care that hospitals provide to patients who cannot afford to pay. Under IRS Section 501(r), nonprofit hospitals — about 58% of U.S. community hospitals — must maintain a written Financial Assistance Policy, publicise it, and consider applications against it. The law requires the policy; it does not set the income threshold, and it does not guarantee anyone free care. Each hospital sets its own thresholds, so the only way to find out is to apply.
Who qualifies for charity care?
Eligibility varies by hospital, but most programs cover patients with household income up to 200-400% of the Federal Poverty Level. Some also consider medical debt relative to income, regardless of earnings.
Can I apply after receiving a bill?
You may still be able to apply when a bill is months old. For tax-exempt hospital facilities, the federal application period extends at least 240 days after the first post-discharge billing statement, and the facility may accept applications later under its policy.
What if I'm denied?
You can appeal with additional documentation. Many denials result from incomplete applications. If still denied, ask about payment plans or other assistance programs.
Check Your Eligibility Now
Answer 5 quick questions to see if you likely qualify for charity care.
Charity Care Rules by State
Income thresholds and extra protections vary by state. Pick your state to see the nonprofit hospital financial assistance policies we track there, plus any state-level charity care requirements. Or start with the charity care eligibility checker to see whether you may qualify.
Ready to find affordable care?
Search 9M+ providers with transparent prices