Most patients don't know this: if you received care at a non-profit hospital, the IRS requires that hospital to offer free or reduced-cost care to patients who can't afford to pay. This is called charity care or financial assistance — and it can eliminate your bill entirely.
Who Qualifies?
Under IRS Section 501(r), non-profit hospitals must provide free or discounted care to patients below certain income thresholds. Typical eligibility:
- Free care (100% discount) — income at or below 200% of the Federal Poverty Level (FPL)
- Discounted care — income between 200–400% FPL (sometimes higher — varies by hospital)
For 2025, 200% FPL is approximately $30,120 for an individual, $61,320 for a family of four.
Many hospitals set their thresholds much higher. Some cover patients up to 600% FPL. You won't know until you ask.
How to Apply
- Ask immediately — contact the billing department before your bill goes to collections. Most hospitals have a financial counselor or patient advocate.
- Request the financial assistance application — hospitals are required to make it available. If they don't offer it, ask specifically for their "501(r) charity care application."
- Gather documentation — you'll typically need recent tax returns, pay stubs, or a letter from your employer confirming income.
- Submit and follow up — processing takes 2–4 weeks. Follow up in writing.
Use our Financial Assistance Finder to check your eligibility instantly based on your income and household size.
What If the Hospital Is For-Profit?
For-profit hospitals aren't required by the IRS to offer charity care, but many still do. Always ask. Additionally:
- Check if any portion of your care was provided by a non-profit physician group even at a for-profit facility
- Medicaid may cover you retroactively in some states — worth checking even after care
- Many states have their own hospital financial assistance laws that apply to all hospitals
Protections Under Federal Law
Starting in 2025, medical debt under $500 cannot appear on credit reports under the CFPB's new rule. For larger debts, non-profit hospitals are prohibited from taking extraordinary collection actions (lawsuits, wage garnishment) against patients who haven't been screened for financial assistance eligibility.
If a hospital sent your bill to collections without notifying you about charity care, you may have grounds to dispute the collection and have it removed.
Other Programs to Check
- Medicaid — if your income qualifies, you may be eligible even if you weren't enrolled at the time of service. Some states allow retroactive enrollment.
- Hill-Burton program — some facilities that received federal construction funds are obligated to provide free or reduced-cost care
- State programs — many states have additional assistance programs beyond federal requirements
- Disease-specific organizations — cancer, diabetes, and other disease foundations often have patient assistance funds
Key Takeaways
- Non-profit hospitals are legally required to offer financial assistance — always ask
- Income limits are often higher than you'd expect — up to 400–600% FPL at some hospitals
- Apply before the bill goes to collections
- You have legal protections against aggressive collection if you haven't been offered assistance
Check your eligibility now — enter your income and household size and get your charity care eligibility estimate in under a minute.