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

Childhood Cancer Lantern
Search Saved

Iowa program

Help with a hospital bill (financial assistance and Iowa protections)

The hospital’s financial assistance office can review whether its policy reduces your family’s bill.

What it is

The hospital’s financial assistance office can review whether its policy reduces your family’s bill.

A hospital bill can remain even when your child has insurance. Your hospital can compare your income with its assistance policy and check the services, insurance and financial resources involved. Being within an income band is a reason to discuss help, not a promise that the bill will be written off.

Eligibility rules
  • Your hospital decides its assistance rules, including income, insurance and which bills qualify. Your county also has a small General Assistance fund for what the hospital leaves.
  • Blank Children's policy covers balances left after insurance too. The hospital reviews income, other sources of payment and which clinicians are included before it approves help.
  • UI Health Care considers Iowa families with income up to about $95,620 a year for three people or $115,500 for four. The counselor has the discount that applies at each level.
  • UI Health Care asks for Medicaid review and financial documents. A written decision establishes any award; the income comparison alone does not.
What you get
  • A review for a hospital discount or write-off under its own policy.
  • Iowa limits how much a creditor can garnish each year.
What the help includes
  • Pathology and radiology charges must identify the doctor and label the charge as medical services.
  • If a hospital debt ever went to court, Iowa caps what a creditor can take from wages in a year: for example $1,500 at an income of $30,000, and never more than 10% at higher incomes. Iowa Legal Aid can check the figure for your pay.
  • Blank Children's cancels the whole eligible balance for families up to 200% of poverty, then reduces it by 65% up to 225%, 45% up to 250%, 25% up to 300% and 5% up to 400%.
  • Blank Children's help covers the hospital's own bills and its participating clinicians, not automatically every separate doctor's charge; the counselor has the current dollar table.
If you decide to apply
  1. Ask the hospital’s financial counselor for its assistance policy, application and an itemized bill.
  2. Have household income, bills and insurance statements ready. Ask whether the account can be held during the review.
  3. Ask the county about General Assistance if the hospital’s help leaves a gap.

Stead/UI Health Care financial counseling: 319-384-6275. Blank Children’s financial counseling: 515-241-6277. Other hospitals: their financial assistance office.

After you ask
  • A written assistance decision shows the discount and remaining balance. The hospital policy explains any internal review when assistance is denied.
  • UnityPoint approval ordinarily lasts 12 months, subject to changed financial circumstances. UI Health Care’s counselor can confirm its own approval period.
  • A nonprofit hospital cannot send a bill to collections or sue in the first 120 days after the first statement, and you can apply for assistance for at least 240 days. While a complete application is under review, collection pauses.
Good to know

A qualifying assistance application can require covered hospitals to pause extraordinary collection actions. Ordinary bills and court deadlines can continue. The counselor can confirm the application’s status and any hold in writing.

Other details
  • A payment agreement alone does not mean financial assistance is unavailable. The counselor can check the policy, remaining balance and whether extraordinary collection actions must pause. UI Health Care’s application requests continuing payments while review is pending; that does not remove applicable collection protections.
  • Iowa does not stop a hospital debt from going on your credit report. If one appears, Iowa Legal Aid can check whether it is accurate and help you dispute it.
  • Iowa Legal Aid at 800-532-1275 can review a bill, agreement, collection letter or court notice and identify relevant limits and exemptions. Different hospitals and separate clinicians can have different assistance obligations.

Federal background: Hospital financial assistance and reviewing or negotiating medical bills.

Official sources
Ask your social worker

“Could the hospital reduce our bill even if insurance has paid part of it? Could you help us compare assistance and payment options, check which doctors’ bills are included, and complete the application if appropriate?”

Why I’m asking: I want to understand the amount we actually owe after insurance and financial assistance are reviewed.

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

Request the policy, application and a written explanation of payment options and any collection hold. Signing a payment agreement alone does not establish assistance ineligibility.

Your social worker

The hospital's financial counsellor gives you the policy and helps with the application.

The care team

Records and letters when the application asks for them.

Who decides
The hospital decides its own assistance; the county decides General Assistance.
Ask the billing office
“Please send me your financial assistance policy and application, and an itemised bill. Please hold this account while the application is decided, and do not put me on a payment plan before then.”

How to apply

First step: Write to the hospital billing office asking for the financial assistance policy, the application form and an itemised bill, and ask them to hold the account.

  1. Ask the hospital's billing office in writing for the financial assistance policy and the application form.
  2. Ask for an itemized bill and discuss financial assistance and payment options. A payment agreement alone does not rule out assistance.
  3. Ask your county whether its General Assistance covers any of the medical need.

Official application / program page ↗

Where it starts: Ask the hospital in writing for its financial assistance policy and application, and ask the county about General Assistance.

What to gather

  • Every bill and statement
  • Proof of household income
  • The insurance explanation of benefits

How long: Set by the hospital's own policy, not by state law.

What a yes looks like

A written discount or write-off on the account, with the balance restated.

What a no looks like, and the next move

Ask for the reason in writing and for the appeal route inside the hospital's policy, then ask the county about General Assistance.

Watch out

  • There is no statewide Iowa schedule. The discount comes from the hospital's own policy.
  • No Iowa ban on credit reporting, interest or lawsuits over medical debt was found.
  • County General Assistance is county by county. It is not a statewide hospital-bill grant.
  • A payment agreement alone does not make financial assistance unavailable. The counselor can check the policy, remaining balance and any required collection hold.

The numbers and the rules

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

What it is worth

No statewide charity-care schedule. Garnishment is capped per creditor per year, starting at $250; the University of Iowa keeps a duty to indigent patients.

  • $250/year — Lowest annual per-creditor garnishment cap
  • $10 — Top-tier annual garnishment ceiling as a share of earnings

Legal protection: The University of Iowa Hospitals keeps a statutory obligation to indigent patients · Public, county and municipal hospital obligations are preserved by the licensure chapter · Pathology and radiology charges must name the doctor and identify the charge as medical services · Annual per-creditor caps on wage garnishment

What it costs the family: None to ask.

The eligibility facts, as published

Who
anyone with an Iowa hospital bill
State schedule
NOT FOUND: no uniform statewide free-care or discount percentages, insured-patient rule or state payment fund was located
County route
County General Assistance is set county by county under section 252.25

The trap: "Iowa has no charity-care law" is too broad, but so is expecting a statewide schedule. The real discount usually comes from the hospital's own policy under federal nonprofit rules, so ask the hospital for its policy and application first.

Where I read this

← Back to your options