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Hospital Financial Assistance: How Charity Care Works and How to Apply After the Bill Arrives

An empty hospital corridor with waiting chairs, with a sticky note reading “240 days”.
Photo by Tasha Kostyuk on Unsplash

The envelope from the hospital holds a balance, a due date and a tear-off payment slip. It looks like there are two choices: pay it now, or sign up for a payment plan that could run for years. There's a third, and a nonprofit hospital is required to tell you about it. The notice is usually one sentence in small type near the bottom of the bill, or on the back, and plenty of people never see it.

See the 6 steps to apply

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By Margaret Linwood · Updated Sep 29, 2026 · Reviewed against IRS section 501(r) rules, CFPB, HHS 2026 poverty guidelines, KFF, state attorneys general

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Nonprofits make up about 58% of community hospitals in the U.S., by KFF's count. Each one has to keep a written financial assistance policy, which most people call charity care, saying who gets free or discounted care and how to apply. Federal law doesn't set the income lines, though. Every hospital draws its own.

The help often goes unclaimed. Nonprofit hospitals reported $2.7 billion in bad debt for 2019 that likely came from patients who qualified and never got help. That's from KFF's review of hospital tax filings. Having insurance doesn't automatically rule you out. And the order you do things in matters more than you'd think.

See if your state goes further

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Five things to look for in a hospital's policy

A nonprofit hospital has to post its policy, the application and a plain-language summary on its website, and hand out free paper copies. A handful of lines in it decide how your application goes.

  1. The income lines. Each hospital sets its own, as a share of the federal poverty level. In one study of nonprofit hospitals, free-care limits ran from 41% of that level all the way to 600%.
  2. What it says about insurance. Many policies cover what's left after insurance pays, including the deductible and coinsurance. Some limit help to people with no coverage at all.
  3. Assets, residency and timing. Check whether assets count, whether you have to live in the state or the hospital's service area, and whether the deadline is shorter than you'd assume.
  4. Which doctors it covers. Doctors who treated you in the hospital often bill on their own. The policy has to list which providers it covers and which it doesn't.
  5. The price cap. Patients who qualify can't be charged more than the "amounts generally billed" to insured patients for the same care.

The policy shows whether you might be in range. The article covers the deadlines, the application itself, and the order of steps that keeps a discount on the table.

See the mistakes that cost the discount

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