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Financial assistance programs, sometimes called “charity care,” provide free or discounted health care to people who need help paying their medical bills. These programs may help patients who do not have insurance and patients who have insurance but are underinsured. These programs may be provided by your medical care provider and your state. Additionally, there may be non-profit organizations or advocacy groups that can help you.
The Affordable Care Act (ACA) requires hospitals to have a written Financial Assistance Policy (FAP) and a written Emergency Medical Care policy . These policies should be widely publicized (for example, an easily seen written notice on billing statements and public displays) and must include specific information such as:
- Eligibility criteria for financial assistance and whether the care is free or discounted.
- Basis for calculating amounts that you are charged.
- How you apply.
As part of the hospital intake or discharge process, the hospital must offer you a paper copy of the plain language summary of the FAP. This summary must include:
- A brief description of the eligibility requirements and assistance offered under the FAP.
- A brief summary of how to apply for assistance under the FAP.
- The direct website address (or URL) and physical locations where the individual can obtain copies of the FAP and FAP application form.
- Instructions on how the individual can obtain a free copy of the FAP and FAP application form by mail.
Steps to take for charity care or financial help with medical bills
1. Ask for a copy of the policy.
Ask for a copy of the hospital’s financial assistance policy up front. By law, the policy must be provided free of charge and must tell you how to apply for help. You can ask whether the policy is available in your preferred language in addition to English.
2. Fill out an application form.
Fill out the application with information about your income, including last year’s tax forms or a current pay stub, and your expenses, including your rent or mortgage payment, utilities, credit cards, and other expenses.
3. Ask questions about the process.
Ask your provider how long it takes to process your application for financial assistance, how to get answers to questions about the application, and what happens with your bill in the meantime.
4. Notify any debt collectors, if they are trying to collect from you
Notify any debt collectors trying to collect on the hospital bill that you’re seeking financial assistance for the bill. You can tell them to pause collections while that is pending.
5. Follow up
Follow up with the service provider and its billing department about the status of your application as necessary.
More information about charity care or financial assistance policies is available on the IRS’s website . In exchange for nonprofit hospitals being treated favorably under federal tax laws, they are required to follow the requirements for providing help to people who need it. If you suspect the hospital is NOT following these requirements, notify the IRS .
Even if a hospital is for-profit or private, they may have a financial assistance policy that can help you pay your medical bills. Ask your hospital for information about their policy, including the eligibility requirements and how you can apply.
Some states have charity care laws that require hospitals to provide free or discounted care to patients meeting requirements, sometimes based on income. Here are some of the states that provide protections:
- 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.
Even if your medical bill is in collection or you have been sued for the debt, you may still want to apply for charity care or financial assistance. You can also request that the debt collector stop collection activity while your application is pending with the hospital. Here is a sample letter that you can use or modify to send to the debt collector. Telling the debt collector to stop contacting you does not stop the debt collector or the hospital from using other legal ways to collect the debt from you if you owe it.
Where can I go if I need more help?
If you have problems with your hospital’s financial assistance policy or application or are unable to resolve your billing dispute to your satisfaction, you have several options.
Consumer Assistance Programs. Many states provide help for consumers experiencing problems with their health insurance. This state map will help you find assistance in your state or territory.
Centers for Medicare & Medicaid Services offers detailed information about your protections against surprise medical bills, including a help desk for medical billing questions and ways to submit a complaint if you believe your facility, provider or insurer isn’t following the rules.
State agencies such as your state attorney general and state insurance department or insurance commissioner may also offer helpful information as well as a complaint process.
Legal Services. If you need a lawyer, there may be resources to assist you, and you may qualify for free legal services through legal aid.
CFPB. If you have a problem with debt collection and a debt you don’t owe because the bill should have been or has been covered by a Financial Assistance Plan or charity care, or if you have a problem with these bills being reported on your credit report, you can submit a complaint with the CFPB online or by calling (855) 411-CFPB (2372).
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