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

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District of Columbia program

Reduce your hospital bills (financial assistance)

DC hospital rules offer no-charge care for qualifying uninsured patients or services insurance does not cover.

What it is

DC hospital rules offer no-charge care for qualifying uninsured patients or services insurance does not cover.

Ask the social worker to compare the hospital’s own financial-assistance policy with the District uncompensated-care rule. The hospital, type of bill, insurance and its income calculation matter; income alone does not establish an award.

Eligibility rules
  • The posted District rule uses income at or below 200% of poverty, assessed using the prior three months annualized or the prior 12 months. This is a review of qualifying care within the hospital’s uncompensated-care obligations, not an automatic waiver of every insured deductible. Hospital financial-assistance policies have their own income and documentation rules.
  • Uninsured, or insured but needing a service the plan will not cover; the help is given on request.
  • The cited District eligibility section does not establish a District-residency requirement. A hospital’s own financial-assistance policy may separately have service-area or residency conditions.
What you get
  • No charge for qualifying care under the District rule.
  • An outpatient decision within 5 business days, or an inpatient decision before discharge.
Coverage details
  • At Children’s National, the written award normally lasts six months to one year; its dates and specialty limits control. The website’s one-year summary does not guarantee a year in every case. Hospital, Regional Outpatient Center and included affiliated or Children’s National Medical Associates bills may qualify. Independent clinicians and Children’s Pediatricians & Associates, LLC are excluded from this policy.
  • At MedStar Georgetown, the District schedule gives full assistance through 200% of poverty. Its 201–250%, 251–300%, 301–350% and 351–400% bands give 80%, 60%, 40% and 20% discounts. Those discounts use the policy’s Medicare-based amounts-generally-billed basis, not unrestricted gross charges.
If you decide to apply
  1. Talk with the social worker about requesting a review under both the District uncompensated-care rule and the hospital’s own policy. Keeping a written copy can help track the request.
  2. Have income records, insurance information and bills or planned services ready.
  3. Ask for the hospital's own financial-assistance review too.

The hospital, under District rules · Official page ↗

After you apply
  • Children’s National’s policy describes a decision within two business days after a complete application. Ask which accounts are held during review; approval protections are not a universal pause on every pending bill. Financial counseling: 202-476-5505 or 1-800-787-0021.
  • MedStar ordinary assistance runs for one year from application; hardship assistance uses a separate 12-month period tied to care. Previously billed care has a 240-day first-bill application provision. The hospital’s policy pauses billing and collection during assistance review. It describes a likely-eligibility response within two business days and a final decision within 14 days after required information is received. An appeal has a 30-day request period and a 30-business-day response standard. Financial counseling: 844-817-6087.
Good to know

You can apply with insurance, and again after Medicaid is in place; they cover different parts of the bill. New DC medical-debt protections passed in 2026 are not yet in force.

The District rule and hospital policy
  • Children's National cancels the whole eligible bill for a family under 400% of poverty; approvals last six months to a year, and some doctors bill separately. MedStar Georgetown gives free care under 200% of poverty and discounts up to 400%, with a hardship review near 500%.
  • While a complete assistance application is under review, a nonprofit hospital pauses collection; ask for that in writing.
  • District rules give no-charge hospital care to families under 200% of poverty when uninsured, or when the plan will not cover a service. An outpatient decision is due within five business days, an inpatient one before discharge.

Federal background: Nonprofit hospitals must publish a financial-assistance policy; hospital policies can extend beyond District minimums.

Official sources
Ask your social worker

“Which hospital bills could free care or financial assistance reduce, and what would remain? Could you help us compare both policies and prepare a request if we qualify?”

Why I’m asking: I want to understand which bills could be reduced and whether any charges would remain.

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 in writing, name the rule, keep the copy and diary the deadline.

Your social worker

The hospital financial counsellor takes the request and decides it.

The care team

Records and letters when the application asks for them.

Who decides
The hospital makes the determination under District rules.
Ask the billing office
“I am asking for uncompensated care under the District's hospital rules. Our income is at or under twice the poverty level. Please give me the determination within five business days.”

How to apply

First step: Write to the hospital financial counsellor asking for uncompensated care under the District rules, and keep a copy.

  1. Ask the hospital financial counsellor in writing for uncompensated care, naming the District rule.
  2. Ask for the decision within five business days, or before discharge if your child is an inpatient.
  3. Apply for the hospital's own assistance at the same time: it usually reaches further.

Official application / program page ↗

Where it starts: Write to the hospital financial counsellor asking for uncompensated care under the District rules, and ask for the decision within five business days.

What to gather

The diagnosis letter, the child’s insurance card, and the last two pay stubs cover most applications. The official page lists the rest.

How long: Five business days for outpatient care, or before discharge for an inpatient.

What a yes looks like

A written determination and a zero balance for the qualifying care.

What a no looks like, and the next move

Ask for the reason in writing, apply for the hospital's own assistance, and call the health care ombudsman on 202-724-7491.

Watch out

  • It only works on request. Nobody applies it for you.
  • A much stronger DC medical debt law passed in 2026 but is not in force yet.

If they say no, quote this: DC health planning regulations: "That there will be no charge for uncompensated care" for a patient at or below 200% of the federal poverty level, decided within 5 business days of a request.

Dates that change this

2026-08-20: The Medical Debt Mitigation Amendment Act of 2026 would add free care to twice the poverty level, sliding discounts to five times it, a 180-day wait before collection, a 3% interest cap, a ban on liens on a home and a ban on reporting medical debt to credit agencies. It applies only six months after its cost is put in an approved budget, and the Code still records it as not implemented. Do not rely on it yet.

2012-01-01: The free-care regulations were published in 2012 and no newer consolidated version was found. The statute they sit under is current. (not yet confirmed against the final rule)

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

No charge at or below twice the poverty level for an uninsured patient or an uncovered service, decided in five business days or before discharge.

  • $200 — Income ceiling for the District free-care rule, as a share of the poverty level
  • $5 — Business days for an outpatient decision after a request
  • $3 — Share of operating costs used for the hospital uncompensated-care assurance

Legal protection: No charge for care that qualifies as uncompensated care · A decision inside five business days for outpatient care, or before discharge for an inpatient

What it costs the family: Nothing to ask.

The eligibility facts, as published

Income
At or below twice the poverty level
Other
Uninsured, or insured but needing a service the plan will not cover; the help is given on request
Residency
The regulations distinguish District residents from others in the reporting, so say you live in the District if you do

The trap: The free-care rule works on request. Nobody applies it for you: ask the financial counsellor, in writing, and ask for the decision in the time the rule gives.

Where I read this

← Back to your options