Federal, exists in every state

Ask the hospital to reduce your bill

Hospital financial assistance can reduce eligible bills, including some costs left after insurance.

What it is

Hospital financial assistance can reduce eligible bills, including some costs left after insurance.

Tax-exempt hospitals must have a written financial-assistance policy. Insured families can qualify under that policy. The financial counselor can check your household income and explain which bills are included.

Eligibility rules

The federal application period at a tax-exempt hospital lasts at least 240 days after the first post-discharge bill.
Federal rules generally bar extraordinary collection actions for at least 120 days after that first bill. Delaware’s separate medical-debt law adds protections.
An approved timely application can require a refund of payments above the assistance amount when the difference is $5 or more.
Nemours currently gives qualifying uninsured families full help below 250% of poverty and an 80% discount from 250% to below 300%; insured balances are reviewed case by case. Its policy is separate from Delaware’s minimum discounts starting January 1, 2027. The financial counselor can check the date, each account and which clinicians are covered.
Nemours’s policy effective January 27, 2026 requires annual recertification and provides at least 240 days after the first statement to request help. The financial counselor confirms the current covered-clinician list and the eight-person income figure.

What you get

A reduction or write-off of eligible hospital bills.
A refund when an approved application shows you overpaid by $5 or more.

If you decide to apply

Ask the hospital financial counselor for the policy, application and list of covered doctors.
Have ready income records, insurance statements and bill account numbers.
Ask what collection activity pauses during review and request the answer in writing.

Your hospital’s financial counselor

Good to know

Nemours’s policy covers its divisions and employed clinicians; independent billers may be outside it. Each account needs checking.

Official sources

Ask your social worker

“What are the benefits and drawbacks of asking for hospital assistance, and could you help us apply and check which bills it covers?”

Why I’m asking: We want to understand what we owe after insurance and hospital assistance.

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.

Call the financial counselor and say “financial assistance policy”.
Ask which providers are covered by it.
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.

Hospital	Free care up to	Discounts up to	Insured families	Financial counselor
Nemours Children’s Hospital, Delaware · policy	250% FPL	300% FPL	yes	844-551-2065

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

Financial Assistance Policies for Tax-Exempt Hospitals — Internal Revenue Service, read August 27, 2026
26 CFR 1.501(r)-1: Definitions (financial assistance application period) — GovInfo (CFR 2025), read September 8, 2026
26 CFR 1.501(r)-6 and -7: Billing and collections; effective dates — GovInfo (CFR 2025), read September 8, 2026
IRS: Billing and collections — section 501(r)(6) — Internal Revenue Service, read September 8, 2026

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