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How to apply for hospital charity care (financial assistance)

US patients · Last checked: 2026-10-25

Not legal or financial advice. This is general information for US patients, summarized from the official sources listed below. Rules vary by state and by situation, and they change. For advice about your case, talk to a lawyer, your state's consumer assistance program, or the official help lines named here. Last checked: 2026-10-25.

Many hospitals can reduce or forgive a bill through financial assistance, often called charity care. According to CMS, nonprofit hospitals must give financial assistance to eligible patients who can't afford to pay, and other facilities may offer it too.

What the federal rules require of nonprofit hospitals

• Under IRS Section 501(r)(4), each nonprofit hospital facility must have a written financial assistance policy (FAP) covering emergency and other medically necessary care.
• The FAP must state the eligibility criteria, whether help means free or discounted care, how amounts are calculated, and how to apply.
• The policy, the application form and a plain-language summary must be on a website, free to download, without creating an account, and paper copies must be free on request.
• Billing statements must carry a notice that financial assistance is available, with a phone number and web address.
• If you're eligible, you can't be charged more than the hospital's "amounts generally billed" (AGB) for emergency or medically necessary care.
• The FAP must list which other providers working in the hospital (for example, separate doctor groups) are and are not covered. Check this, since you may get separate bills.

Steps

1. Search the hospital's name plus "financial assistance", or call the billing office and ask for the policy, application and plain-language summary (CMS suggests both).
2. Read the eligibility rules, the application method, the deadline, and who to call with questions.
3. Gather what the application asks for. The IRS says a hospital can't deny help for leaving out a document the policy or form didn't specifically require.
4. Apply, keep copies, and note the date you sent it. Ask how long processing takes and what happens to your bill meanwhile.
5. Use our financial assistance request letter if you want a written record.

Timing and collections protections (501(r)(6))

• The application period is at least 240 days from the first bill sent after you left the hospital. Hospitals may accept applications at any time after that.
• Before "extraordinary collection actions" (such as credit reporting, selling the debt, lawsuits, liens or wage garnishment), the hospital must wait at least 120 days after that first bill and give at least 30 days' written notice.
• Once you submit a complete application in the application period, the hospital must suspend those collection actions and decide your eligibility in writing.
• If you're approved, the hospital must refund amounts you overpaid (unless under $5) and take reasonable steps to reverse collection actions, including removing negative credit report entries.

These IRS rules apply to tax-exempt (nonprofit) hospitals. For-profit hospitals may have their own programs, and some states have their own charity care laws. Check your state.

Sources (checked 2026-10-25)

• CMS: Apply for medical bill financial assistance
• IRS: Financial assistance policy, Section 501(r)(4)
• IRS: Billing and collections, Section 501(r)(6)

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