The short version
Every nonprofit hospital must have a written financial assistance policy. Federal law requires the policy to exist, but it does not set one national income cutoff: each hospital sets its own. Many hospitals give free care at or below 200 percent of the federal poverty level and discounted care above that. You generally have 240 days from the first bill to apply, and aggressive collections must pause while a complete application is being decided.
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2026 federal poverty guidelines, and what hospitals do with them
| Household size | 100% of poverty level | 200% (free care is common here) | 300% (discounts often reach here) |
|---|---|---|---|
| 1 | $15,960 | $31,920 | $47,880 |
| 2 | $21,640 | $43,280 | $64,920 |
| 3 | $27,320 | $54,640 | $81,960 |
| 4 | $33,000 | $66,000 | $99,000 |
| 5 | $38,680 | $77,360 | $116,040 |
| 6 | $44,360 | $88,720 | $133,080 |
| 7 | $50,040 | $100,080 | $150,120 |
| 8 | $55,720 | $111,440 | $167,160 |
2026 HHS guidelines for the contiguous United States and DC. Alaska and Hawaii are higher. Add $5,680 per person above 8 for the 100 percent line.
How to apply
- Ask the billing office for the financial assistance application and the plain language summary of the policy. They have to provide both.
- Apply even if you have insurance. Assistance can cover the part the plan left to you.
- Send the complete application with income documents before the 240 day window closes, and keep copies.
- While a complete application is pending, the hospital must pause extraordinary collection actions.
- If you already paid and then qualify, many policies refund amounts above what you should have owed.
Worth knowing
- A payment plan is not assistance. Ask for the assistance decision first, because a plan can bury a bill you never had to pay in full.
- For profit hospitals are not covered by the federal rule, but many run their own charity programs. Ask anyway.
- Free help exists: Dollar For presses hospitals on these applications, and the Patient Advocate Foundation can be reached at 1-800-532-5274.