Duke Health (Duke University Hospital) financial assistance: the complete 2026 guide

The table below shows 2026 federal poverty levels across common household sizes. The free-care threshold at Duke Health (Duke University Hospital) is approximately 200% FPL and discount eligibility extends to approximately Up to 300% FPL + medical indigence provision. Always confirm current thresholds in the hospital's published Financial Assistance Policy before applying.

1. Request an itemized bill first

   Before doing anything else, call Duke Health Patient Revenue Management at 1-919-684-8111 and request a fully itemized statement of every charge on your bill. Review it carefully — billing errors are common. Correcting errors before applying means charity care is applied to the correct baseline amount.

2. Read the Financial Assistance Policy

   Download and read Duke Health (Duke University Hospital)'s Financial Assistance Policy at dukehealth.org/paying-for-care/financial-assistance. Pay particular attention to the income tiers, documentation requirements, and appeal process before starting the application.

3. Complete the application

   Download the financial assistance application from the same page, or request a paper copy at any Duke Health (Duke University Hospital) admissions or billing office. Complete every section — incomplete applications are the most common reason for processing delays and initial denials.

4. Gather your documentation

   Collect all documents listed in the section below. Make photocopies of everything before submitting. If mailing, use certified mail with return receipt to create a dated delivery record.

5. Submit and follow up

   Submit your completed application and supporting documents. Follow up by phone after 2–3 weeks to confirm receipt, get a case reference number, and ask about the expected processing timeline.

6. Appeal if denied

   A denial is not final. Request the specific reason in writing and submit a formal written appeal with additional or corrected documentation. Read our complete guide to appealing a denied charity care application for a step-by-step process.

• DUHS Financial Assistance Application
• Most recent federal tax return (Form 1040)
• Recent pay stubs (last 2–3 months)
• Government benefit award letters
• Bank statements if self-employed or income is irregular
• If claiming medical indigence: documentation of total patient liability
• If no income: signed self-attestation letter

Duke Health's medical indigence provision is one of the most practically useful patient protections of any major US hospital: if your total Duke bill exceeds 15% of your current or prior year annual household income, you automatically qualify for consideration — regardless of your income level relative to FPL. This means a family earning $120,000 with a $25,000 Duke bill (which is more than 20% of their income) can qualify for assistance even though 300% FPL for a family of four is only $99,000.