Financial assistance, sometimes called charity care, may provide free or discounted health care if you need help with medical bills. Ask your hospital for its financial assistance policy to see the eligibility requirements and how to apply.
What to have in front of you
When you prepare to ask about assistance or fill out an application, have these items available:
- Your hospital bill.
- A copy of the hospital’s financial assistance policy and application form.
- Information about your income, such as last year’s tax forms or a current pay stub.
- Information about your expenses, including rent or mortgage payments, utilities, credit cards, and other expenses.
If a debt collector is trying to collect the hospital bill, you can also let the collector know that you are seeking financial assistance.
Who may be able to get help?
Financial assistance programs may help patients who do not have insurance. They may also help patients who have insurance but are underinsured.
Your medical care provider or your state may offer a program. Nonprofit organizations and advocacy groups may also be able to help.
The hospital’s policy explains its eligibility criteria and whether assistance is free or discounted care. Ask the hospital for its policy and application information to see what is available for your situation.
Even if a hospital is for-profit or private, it may have a financial assistance policy. Ask about its eligibility requirements and how to apply.
Ask for the hospital’s policy
Ask for a copy of the financial assistance policy up front. The policy must be provided free of charge and must tell you how to apply for help. You can also ask whether it is available in your preferred language in addition to English.
The Affordable Care Act requires hospitals to have a written Financial Assistance Policy and a written Emergency Medical Care policy. These policies should be widely publicized, including through easily seen notices on billing statements and public displays.
The financial assistance policy must include information about:
- Eligibility for assistance and whether care is free or discounted.
- The basis for calculating the amounts charged.
- How to apply.
As part of the hospital intake or discharge process, the hospital must offer you a paper copy of a plain language summary of its Financial Assistance Policy. The summary includes a brief description of eligibility and assistance, a summary of how to apply, and where to get the policy and application form. It also explains how to request free copies by mail.
Fill out the application and ask questions
Fill out the application with information about your income and expenses. Examples of income information include last year’s tax forms or a current pay stub. Expenses can include your rent or mortgage payment, utilities, credit cards, and other expenses.
The Consumer Financial Protection Bureau suggests asking your provider:
- How long will it take to process the application?
- How can you get answers to questions about the application?
- What happens with the bill while the application is being processed?
Follow up with the service provider and its billing department about the status of your application as necessary.
If the bill is in collection
You may still want to apply for financial assistance if your medical bill is in collection or you have been sued for the debt.
If a debt collector is trying to collect the hospital bill, notify the collector that you are seeking financial assistance. You can ask the collector to pause collection activity while your application is pending with the hospital.
The Consumer Financial Protection Bureau offers a sample letter you can use or modify to send to the debt collector. Telling a debt collector to stop contacting you does not stop the collector or hospital from using other legal ways to collect a debt from you if you owe it.
Check for state assistance
Some states have charity care laws requiring hospitals to provide free or discounted care to patients who meet the requirements. In some cases, the requirements are based on income.
California, Connecticut, Illinois, Maine, Maryland, Nevada, New Jersey, New York, Rhode Island, and Washington have protections that apply to all hospitals. Louisiana, Oregon, and Texas have protections that apply only to nonprofit or state hospitals.
Colorado, Massachusetts, and South Carolina have state-run financial assistance programs.
Where to ask for more help
If you have a problem with a hospital’s policy or application, or cannot resolve a billing dispute to your satisfaction, you have several options:
- Consumer Assistance Programs: Many states help consumers who have problems with health insurance.
- Centers for Medicare & Medicaid Services: This agency offers information about protections against surprise medical bills, a help desk for billing questions, and a way to submit a complaint.
- State agencies: Your state attorney general, insurance department, or insurance commissioner may offer information and a complaint process.
- Legal services: If you need a lawyer, you may qualify for free legal services through legal aid.
- Consumer Financial Protection Bureau: You can submit a complaint online about certain debt collection or credit reporting problems involving medical bills.
If you suspect a hospital is not following the requirements for providing financial assistance, you can notify the IRS.
Where this comes from
Consumer Financial Protection Bureau: Is there financial help for my medical bills?