Written by a parent, not a doctor. Nothing here is medical advice.

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Federal, exists in every state

Reduce hospital bills (financial assistance)

The hospital’s written financial-assistance policy can reduce or erase eligible bills, including some bills left after insurance.

What it is

The hospital’s written financial-assistance policy can reduce or erase eligible bills, including some bills left after insurance.

Hospital assistance can reach families above the Medicaid income line. The financial counselor checks your hospital’s policy, household income and remaining bills. Different policies may apply to insured and uninsured families.

Eligibility rules
  • Federal rules apply to tax-exempt hospitals: at least 240 days to apply after the first bill after discharge. Hospital tax status must be confirmed.
  • A qualifying nonprofit hospital must wait at least 120 days after that bill before extraordinary collection actions. Timely applications have further protections during review.
What you get
  • A discount or write-off under the hospital’s policy.
  • At qualifying nonprofit hospitals, refunds of overpayments of $5 or more after assistance approval.
What coverage means
  • Children’s of Alabama links separate December 2015 policies. For uninsured families, the table gives a 100% discount through 200% of poverty and 50% at 201%–300%, after the ordinary uninsured adjustment and subject to income and asset conditions. For underinsured families, the table gives 50% at 0%–200% with at least $2,500 owed, and 30% at 201%–300% with at least $5,000 owed. The policies also contain a liability provision tied to 15% of annual adjusted gross income. The counselor applies the full policy to each account; insured children do not automatically receive free care.
  • Huntsville’s underinsured table gives discounts of 100% at 0%–200% of poverty, 50% at 201%–250%, 40% at 251%–300%, 25% at 301%–350% and 15% at 351%–400%. Discounts use the policy’s Medicare-rate basis and asset conditions. The narrative says below 400%, so a family at exactly 400% needs the hospital’s written clarification. Its catastrophic route limits liability to the lesser of 30% of annual family income or amounts generally billed, subject to the policy.
  • Hospital and employed-clinician bills may qualify, while independent clinicians can bill separately. Children’s exclusions include UAB surgeons/psychiatry, Pediatric Anesthesia Associates and Pediatric Radiology Associates. Huntsville excludes independent clinicians, outpatient prescriptions and specified elective services. The counselor can check the actual billing list.
If you decide to apply
  1. Ask the hospital financial counselor for the policy, application, income table and list of covered doctors.
  2. Have ready: income records, insurance statements and the bills or account numbers.
  3. Ask which collection actions pause during review and for written confirmation.

Your treating hospital financial counselor

After you apply
  • Children’s uninsured policy sets a 30-day decision standard for a complete application and annual reevaluation; changed finances can trigger review. Huntsville generally decides a complete application within 30 days. The insured Children’s and Huntsville approval periods come from the award letter, not the processing time.
  • At a hospital covered by federal 501(r), an approved timely application can require a refund of overpayments of $5 or more. The written decision identifies the covered accounts and period.
Good to know

Doctors billing separately may not be covered by the hospital’s policy. A payment plan changes when you pay; it does not establish the correct balance.

Other details
  • Children’s current links point to December 2015 policies; Huntsville’s linked policy was last reviewed July 1, 2022. A newer application form does not change a policy’s effective date. The counselor can identify which policy governs your accounts.
  • Children’s financial counselors are at 205-638-2722; Huntsville’s are at 256-265-9689. They can confirm covered doctors, the legal entity and tax status on each bill, and the policy and award dates. Huntsville can also resolve the exact-400% boundary in writing.
  • For USA Health Children’s & Women’s Hospital, the social worker can obtain the current income and asset rules, insured-patient policy, approval period, covered-doctor list and counselor contact through USA Health’s financial-assistance page. The hospital can confirm the billing entity and tax status; another hospital’s income table does not apply.
  • Children’s primary-care exception provides an amounts-generally-billed adjustment rather than the full hospital free-care schedule. The counselor can check whether that exception applies to a particular bill.
Official sources
Ask your social worker

“Could you help us apply for the hospital's financial assistance and check which bills it covers?”

Why I’m asking: I want the hospital to check our current income and patient bills before we agree to a payment plan.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Ask for the application, send proof of income, and do not pay or put a bill on a card while it is open.

Your social worker

The social worker connects you with the financial counselor. The counselor checks Medicaid and explains which providers the assistance covers.

The care team

Records and letters when the application asks for them.

Who decides
The hospital's financial-assistance office under its written policy
Ask the billing office
“I would like to apply under the hospital's financial assistance policy. What is the income ceiling, which providers are covered by it, and can you hold collections while it is reviewed?”

How to apply

First step: Call the hospital's financial counselor, say “financial assistance policy”, and ask for the application, the income table and the list of covered providers.

  1. Call the financial counselor and say “financial assistance policy”.
  2. Ask which providers are covered by it.
  3. Ask for a collection hold while it is reviewed.

Where it starts: Apply to the hospital; the financial counselor checks Medicaid at the same time

What to gather

  • Proof of household income (pay stubs or last tax return)
  • The insurance card and recent explanation-of-benefits statements
  • The bills or account numbers

How long: A decision within weeks of a complete application. A nonprofit hospital may not sue, report the debt or garnish wages for at least 120 days after the first bill after discharge, and holds collections while it decides.

What a yes looks like

A letter naming the discount percent and the period it covers (often 12 months). If you paid before the decision, a refund of the difference follows. Re-apply when it lapses.

What a no looks like, and the next move

“Over the income limit”: ask about the high-medical-expense branch, a prompt-pay discount and an interest-free plan. Then go to bill negotiation.

Watch out

  • Apply before paying if you can. If you already paid, apply anyway: within 240 days of the first bill after discharge, an approved application means the hospital refunds what you paid above the assistance amount ($5 or more).
  • Doctors who bill separately (anesthesia, radiology, some oncologists) may not be under the hospital's policy. Ask which providers are covered.
  • Insured families count too: some hospitals have a high-medical-expense branch that discounts at any income when bills pass a share of income.

Each hospital’s own policy

The federal rule sets the floor; each hospital’s policy sets the actual numbers. “Unknown” means the policy could not be read yet: call the number and ask.

HospitalFree care up toDiscounts up toInsured familiesFinancial counselor
Children's of Alabama · policy200% FPL300% FPLyes205-638-2722
Huntsville Hospital for Women & Children · policy200% FPL400% FPLyes256-265-9689
USA Health Children's & Women's Hospital · policyunknownunknownunknownunknown

The numbers and the rules

The arcane layer, kept on purpose. Checked September 8, 2026.

What it is worth

The hospital's own bill reduced or written off entirely under its published schedule. Collections held while the application is open.

  • Discount or charity write-off — Discount or charity write-off
  • $240 (at least; a policy can allow longer) — Days to apply after the first bill after discharge
  • $120 (at least) — Days after that first bill before the hospital can sue, report the debt or garnish wages
  • $5 (refunded when $5 or more) — Refund of what you paid above the assistance amount

Legal protection: A written policy and application, published · Limits on collection actions while the application is reviewed · At a nonprofit hospital, an application filed within 240 days of the first bill after discharge must be taken (federal rule) · No lawsuit, credit reporting, wage garnishment or sale of the debt for at least 120 days after that first bill · If you already paid and the application is approved, the hospital refunds what you paid above the assistance amount ($5 or more)

What it costs the family: Free application.

The eligibility facts, as published

Tax exempt hospital for federal floor
yes
Policy specific
yes
Insured patients
often eligible; some policies add a high-medical-expense branch at any income; a children's hospital policy often reaches families at 400% of the poverty line and above
Federal 501r floor
nonprofit (tax-exempt) hospitals: application period runs to at least the 240th day after the first post-discharge bill; no extraordinary collection actions for at least 120 days after that bill; refund of amounts paid above the assistance amount when $5 or more

Decisions this site cannot make: Hospital policy eligibility

Expect friction on: Separately billing physicians · Documentation · Application deadlines

The trap: Paying first and then not applying. If you already paid and the application is approved in time, the hospital must refund what you paid above the assistance amount ($5 or more). Doctors who bill separately may not be under the hospital's policy.

What changes by state: Some states set minimum hospital discounts, including California. Your hospital sets its own assistance limits and provides a financial counselor.

Where I read this

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