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Federal law has required this since 2010

Find out if you qualify for free or discounted hospital care

Most nonprofit hospitals in the U.S. are legally required to offer financial assistance to patients who can't fully afford their bills — yet most eligible patients never apply. See where you likely stand in under two minutes, before you pay or set up a payment plan.

100M+people in the U.S. carry medical debt1
$21Bin hospital charity care provided in 20222
2 minto get your free estimate
Illustrative eligibility ranges 2026 FPL data
Income as a percent of the Federal Poverty Level vs. typical charity care generosity A horizontal bar showing that hospitals most commonly offer free care near or below 100-200% of the Federal Poverty Level and discounted care up to roughly 400%, though exact thresholds vary by hospital. 0% 100% 200% 300% 400% 500%+ EX: FAMILY OF 4 ≈ $66,000/YR Often fully free Often discounted Varies by hospital
  • Commonly 100% free care
  • Commonly sliding-scale discount
  • Hospital-specific, ask directly

Illustrative only. Each hospital sets its own income cutoffs in its Financial Assistance Policy (FAP) — yours may be more or less generous than this example. Use the calculator below for an estimate based on your numbers.

Required by federal law

IRS Section 501(r) requires nonprofit hospitals to maintain a written financial assistance policy.

Free, no obligation

This tool only estimates eligibility. It never asks for payment or your Social Security number.

Insured or uninsured

Many policies apply to underinsured patients too, not only people without coverage.

About 2 minutes

A handful of questions about household size, income, and where you were treated.

What is charity care

Hospital charity care, explained simply

"Charity care" — also called financial assistance — is free or discounted hospital care for patients who can't afford to pay their bill in full. It isn't a favor a hospital chooses to do. For nonprofit hospitals, which make up the majority of U.S. community hospitals, it's a condition of keeping their federal tax-exempt status.

Under IRS Section 501(r)(4), every nonprofit hospital facility must adopt a written Financial Assistance Policy (FAP), publish it along with a plain-language summary and application form, and apply it to all emergency and medically necessary care. Hospitals can set their own eligibility rules, but the rules have to exist, be public, and be followed consistently — that's why they vary so much from one hospital to the next.

Two related federal protections matter just as much as the FAP itself:

  • The "amounts generally billed" (AGB) limit — under Section 501(r)(5), a FAP-eligible patient can't be charged more than what insured patients are typically charged for the same care, regardless of the hospital's sticker price.
  • The collections pause — under Section 501(r)(6), a hospital generally can't send your account to collections, report it to a credit bureau, or sue you until it has made a reasonable effort to find out whether you qualify for financial assistance.

This page is educational, not legal or medical advice

CharityCareCheck explains general rules and typical practice. Your hospital's actual policy controls what you qualify for — always confirm details with its financial assistance office. See our about & editorial process page.

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Who qualifies

Do you qualify? The income test most hospitals use

Almost every hospital ties eligibility to your household income as a percentage of the federal poverty guidelines (FPL), published each January by HHS. For 2026, the guideline for one person in the 48 contiguous states is $15,960; for a family of four it's $33,000. A hospital might offer:

  • 100% free care for household income up to roughly 150–200% of FPL ($33,000–$44,000 for a family of four in 2026)
  • A sliding-scale discount — commonly 20% to 90% off — for income between roughly 200% and 400% of FPL
  • Case-by-case "catastrophic" assistance above 400% of FPL when the bill is very large relative to income, at many (not all) hospitals

These exact numbers are examples, not promises — a hospital in a high-cost city may set its free-care line at 300% or 400% of FPL, while another sets it at 125%. How It Works walks through how to read your specific hospital's policy.

01

Income & household size

Hospitals generally use gross household income before taxes, counting everyone who depends on that income — not just the patient.

02

Insurance status

Uninsured patients usually qualify most easily, but many FAPs also cover insured patients with large deductibles or out-of-pocket costs.

03

Where you were treated

Eligibility is set per hospital facility, not per health system. Two hospitals under the same parent company can have different rules.

What it covers

What charity care pays for — and what it usually doesn't

  • Emergency room care

    Covered under the hospital's FAP regardless of ability to pay up front.

    Usually covered
  • Inpatient hospital stays

    Medically necessary admissions billed directly by the hospital.

    Usually covered
  • Hospital-owned outpatient clinics

    Care delivered at clinics the hospital itself owns and bills for.

    Often covered
  • Independent physician bills

    A surgeon or specialist who bills separately from the hospital may not be bound by the hospital's FAP.

    Check separately
  • Ambulance & outside labs

    Third-party ambulance companies and reference labs usually have their own billing and assistance policies.

    Usually separate
  • Outpatient prescriptions

    Medication picked up at a retail pharmacy is typically outside the hospital's FAP.

    Usually not covered
How to apply

How to apply, step by step

  1. Find the hospital's Financial Assistance Policy

    Search "[hospital name] financial assistance policy" or look for a link in the footer of the hospital's website — federal rules require it to be posted.

  2. Request the application & plain-language summary

    You can ask for a paper copy at the registration desk, ER, or billing office at no charge.

  3. Gather income documentation

    Recent pay stubs, a tax return, or a benefits award letter (SNAP, Medicaid, SSI) are typically accepted.

  4. Submit before the deadline

    Federal rules require hospitals to accept applications for at least 240 days after your first post-discharge bill.

  5. Get your determination — and appeal if needed

    If you're approved for a lower tier than expected, you can usually submit more documentation and ask for a re-review.

Watch the 240-day window

Hospitals must let you apply for at least 240 days from your first post-discharge bill, and must give 30 days' notice before reporting you to a collection agency or credit bureau. If you're already in collections, you may still be able to apply — ask the hospital directly.

State rules vary

Charity care rules by state

Federal law sets the floor. Several states layer on stricter income thresholds, shorter response times, or broader eligibility for insured patients. Start with your state's guide:

California

Some of the strictest charity-care rules in the country, including required income thresholds for nonprofit hospitals.

California guide

Texas

State law sets minimum charity-care spending requirements tied to net patient revenue for nonprofit hospitals.

Texas guide

Florida

Charity care obligations are shaped by the state's Health Care Responsibility Act and hospital-specific policies.

Florida guide
Free eligibility estimator

Estimate your eligibility in under 2 minutes

Answer a few questions about your household and the hospital that treated you. This gives you a starting estimate — not a guarantee — before you contact the hospital directly.

Charity Care Eligibility Calculator

Estimates only. Always confirm your result with the hospital's financial assistance office.

Your answers stay in your browser for this session — we don't sell or share what you enter. See our Privacy Policy.
Sources

Where this information comes from

We link directly to primary sources so you can verify anything on this page yourself.

  1. 1.American Medical Association, Council on Medical Service report on medical debt and nonprofit hospital charity care policy — councilreports.ama-assn.org
  2. 2.Johns Hopkins Bloomberg School of Public Health, analysis of 2022 nonprofit hospital community-benefit spending — publichealth.jhu.edu
  3. 3.IRS, "Financial Assistance Policy and Emergency Medical Care Policy – Section 501(r)(4)" — irs.gov
  4. 4.IRS, "Limitation on Charges – Section 501(r)(5)" and "Billing and Collections – Section 501(r)(6)" — irs.gov
  5. 5.U.S. Department of Health & Human Services (ASPE), 2026 Poverty Guidelines — aspe.hhs.gov
  6. 6.Congressional Research Service, "Nonprofit Hospitals, Tax Benefits, and Charity Care" — congress.gov

General disclaimer

CharityCareCheck is an independent educational resource. We are not a hospital, a law firm, a government agency, or a financial advisor, and our estimates are not a guarantee of approval. Learn more about how we research and review this content on our About page.