Federal, exists in every state
Ask the hospital to reduce your bill
Your hospital’s financial-assistance policy can reduce eligible bills, including some bills left after insurance.
What it is
Your hospital’s financial-assistance policy can reduce eligible bills, including some bills left after insurance.
A hospital financial counselor can review the bills your insurance leaves unpaid. The hospital’s own policy and Massachusetts Health Safety Net are different sources of help. Boston Children’s and Dana-Farber bill separately, even when they share your child’s care.
Eligibility rules
- Federal rules require tax-exempt hospitals to publish financial-assistance policies. Each policy identifies covered care, income rules and billing organizations.
- Mass General Brigham’s acute-hospital policy, effective January 1, 2026, provides a full write-off through 150% of poverty and ordinary assistance through 300%. Residence, insurance and covered-service rules apply.
- UMass Memorial’s hospital policy, effective July 11, 2025, reaches 600% of poverty. Eligibility at that level does not mean free care.
- Boston Children’s and Dana-Farber require separate current-policy checks, including help for insured patients and bills from individual clinicians. Dana-Farber Patient Billing Solutions is 617-632-3795. UMass Memorial financial counseling is 508-334-9300; its policy reaching 600% of poverty is not a promise of a full write-off. The financial counselor can identify any full-assistance or high-expense route and exactly which hospital and professional bills it covers.
What you get
- A reduction or write-off of eligible hospital bills under the hospital’s policy.
When bills are high
- Mass General Brigham offers a 70% discount at 251–300% of poverty. At 300.1–600%, the high-expense route requires medical expenses above 30% of income; above 600%, the test is 40%.
- UMass Memorial caps an eligible insured patient’s obligation at 27% of total gross charges, not 27% of the copay. Its policy excludes UMass Memorial Medical Group and Community Healthlink bills.
If you decide to apply
- Ask the hospital financial counselor for its assistance application and the list of doctors whose bills it covers.
- Bring current income records, insurance statements and bills from each billing organization.
- Ask for a Health Safety Net review at the same meeting and a written decision on each route.
After you apply
- Ask which accounts the decision covers and what collection activity pauses during the review.
- UMass Memorial’s hospital policy effective July 11, 2025 describes a one-year approval and up to 12 months of retrospective assistance. Its general application period is 240 days after the first bill, subject to policy conditions; financial counseling can confirm the dates for each account.
Good to know
A payment plan changes when you pay. Financial assistance can change how much you owe.
Separate bills
- Boston Children’s and Dana-Farber need separate policy checks. Dana-Farber financial counseling is 617-582-9820; Mass General financial counseling is 617-726-2191.
Official sources
“Could you help us compare the hospital’s assistance with Health Safety Net, check each separate bill, and help us apply?”
Why I’m asking: I want to know what can reduce the bills before agreeing to a payment plan.
More background and detailed requirements
How this works
A hospital financial counselor can review the bills your insurance leaves unpaid. The hospital’s own policy and Massachusetts Health Safety Net are different sources of help. Boston Children’s and Dana-Farber bill separately, even when they share your child’s care.
- A reduction or write-off of eligible hospital bills under the hospital’s policy.
- Ask the hospital financial counselor for its assistance application and the list of doctors whose bills it covers.
- Bring current income records, insurance statements and bills from each billing organization.
- Ask for a Health Safety Net review at the same meeting and a written decision on each route.
Federal rules require tax-exempt hospitals to publish financial-assistance policies. Each policy identifies covered care, income rules and billing organizations.
Mass General Brigham’s acute-hospital policy, effective January 1, 2026, provides a full write-off through 150% of poverty and ordinary assistance through 300%. Residence, insurance and covered-service rules apply.
UMass Memorial’s hospital policy, effective July 11, 2025, reaches 600% of poverty. Eligibility at that level does not mean free care.
Boston Children’s and Dana-Farber require separate current-policy checks, including help for insured patients and bills from individual clinicians. Dana-Farber Patient Billing Solutions is 617-632-3795. UMass Memorial financial counseling is 508-334-9300; its policy reaching 600% of poverty is not a promise of a full write-off. The financial counselor can identify any full-assistance or high-expense route and exactly which hospital and professional bills it covers.
Mass General Brigham offers a 70% discount at 251–300% of poverty. At 300.1–600%, the high-expense route requires medical expenses above 30% of income; above 600%, the test is 40%.
UMass Memorial caps an eligible insured patient’s obligation at 27% of total gross charges, not 27% of the copay. Its policy excludes UMass Memorial Medical Group and Community Healthlink bills.
Ask which accounts the decision covers and what collection activity pauses during the review.
UMass Memorial’s hospital policy effective July 11, 2025 describes a one-year approval and up to 12 months of retrospective assistance. Its general application period is 240 days after the first bill, subject to policy conditions; financial counseling can confirm the dates for each account.
Boston Children’s and Dana-Farber need separate policy checks. Dana-Farber financial counseling is 617-582-9820; Mass General financial counseling is 617-726-2191.
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 |
|---|---|---|---|---|
| Boston Children's Hospital · policy | unknown | unknown | unknown | unknown |
| Dana-Farber Cancer Institute · policy | unknown | unknown | unknown | 617-582-9820 |
| Massachusetts General Hospital · policy | 150% FPL | 300% FPL | yes | 617-726-2191 |
| UMass Memorial Children's Medical Center · policy | unknown | 600% FPL | yes | 508-334-9300 |
| Baystate Children's Hospital · policy | unknown | unknown | unknown | 413-794-2452 |
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