Missouri program
Help with a hospital bill (financial assistance)
Your hospital’s written financial assistance policy can reduce eligible bills, including some bills after insurance.
What it is
Your hospital’s written financial assistance policy can reduce eligible bills, including some bills after insurance.
Ask the counselor for the policy, the income table and the application in writing; a separate hardship route can apply to very large bills.
Eligibility rules
- BJC’s financial counselor confirms the current income table, family-income cap and bill scope. Its accessible policy describes a 12-month approval and catastrophic-expense review.
- SSM: free care up to 200% of poverty, then discounts that shrink as income rises up to 400%. The counselor can show where your income falls.
- Mercy’s February 1, 2026 table provides free care through 200% of poverty. From 201%–300%, the hospital discount is 80%, with a separate 70% schedule for included professional services. The applicable amounts-generally-billed limit may further reduce the eligible balance.
What you get
- Free or discounted eligible care under the hospital’s own income and hardship rules.
- A written decision about the amount of help.
What the help includes
- BJC’s catastrophic route can limit patient liability over 12 months to 20% of annual family income. It can reach families outside ordinary income eligibility.
- SSM’s separate Medical Indigence review considers catastrophic bills and essential assets, without requiring ordinary income eligibility.
- Children’s Mercy’s January 21, 2026 public table lists full assistance through 300% of poverty: $81,960 annually for three or $99,000 for four. Its public information includes eligible in-network insured balances and says approval typically lasts one year. Counselors at 816-234-3567 confirm the controlling policy, hardship rules and included bills.
- Children’s Mercy’s July 2026 clinician list includes employed clinicians and identified services, but excludes independent affiliated clinicians. Mercy likewise covers only listed professional services; a separate Mercy Clinic policy may apply.
If you decide to apply
- Ask your hospital’s financial counselor for its policy, income table and application.
- Have income details and the bills ready. Ask whether a hardship or catastrophic-expense review is available.
Your treating hospital’s financial counselor
After you apply
- The written decision identifies included bills, the remaining balance and approval dates. BJC describes 12 months, SSM and Mercy generally six months, and Children’s Mercy typically one year. New services and separate professional bills still need checking.
Good to know
Hospital help may not cover a separate doctor’s bill. The billing office can identify which charges its policy includes.
Other details
- A court case needs its own timely response during a hospital assistance review. Legal aid can check protected earnings, interest, deadlines and exceptions. A hospital discount does not cancel a court deadline.
- Covered nonprofit hospitals have federal limits on extraordinary collection actions during a timely qualifying assistance review. These are not a pause on all statements, ordinary contacts, independent-doctor bills or court deadlines. The social worker and legal-aid team can check the particular bill.
- A nonprofit hospital cannot send you to collections or sue in the first 120 days after the first bill, and you can apply for assistance for at least 240 days after it.
- The treating hospital’s own policy matters, including for treatment outside Missouri. Your counselor can confirm its income table, any hardship branch and current legal protections. A Missouri hospital’s table does not follow your child to an unrelated center.
Federal background: Hospital financial assistance.
Official sources
- RSMo 525.030
- RSMo 408.020
- RSMo 408.040
- ARPA project: Medical Debt Forgiveness
- Financial Assistance Policy
- Financial Assistance Policy Income and Discount Tables
- Operations Financial Assistance Policy (Charity Care)
- Hospital and Health Services Financial Assistance Program
- Financial Assistance
- Statewide hospital-assistance minimum and each listed hospital’s policy, duration and bill scope
- Statewide hospital-assistance minimum and each listed hospital’s policy, duration and bill scope
- Statewide hospital-assistance minimum and each listed hospital’s policy, duration and bill scope
- Statewide hospital-assistance minimum and each listed hospital’s policy, duration and bill scope
- Medical debt credit reporting, interest limits and collection pauses in Missouri
“Could the hospital reduce any bills under its income or hardship policy? What would remain outside the help, and could you help us apply if it fits?”
Why I’m asking: I want to understand the hospital’s actual assistance rules before assuming a bill is the final amount.
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 policy, the income table and the application in writing.
Your social worker
The hospital's financial counsellor gives you the policy and helps you apply.
The care team
Nothing.
- Who decides
- The hospital
- Ask the billing office
- “Please send me your financial assistance policy, the income table and the application. If we are over the ordinary line, what is the hardship or catastrophic route and how do we apply for it?”
How to apply
First step: Ask the hospital in writing for its financial assistance policy, income table and application.
- Ask the hospital for its financial assistance policy and application in writing.
- If income is above the ordinary line, ask specifically about the hardship or catastrophic route.
- Ask for an itemised bill before you agree to any payment plan.
Official application / program page ↗
Where it starts: Ask the hospital in writing for its financial assistance policy, its income table and its application, and ask about the hardship or catastrophic route by name.
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: Each hospital sets its own timeline.
What a yes looks like
A written decision reducing or writing off the bill under the hospital's own policy.
What a no looks like, and the next move
If the no is about income, ask about the hardship or catastrophic route, which does not always use the income table.
Watch out
- There is no state income line to point at. Ask the hospital for its own.
- The garnishment and interest rules are general debt law, not medical-debt law.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
No statewide charity-care floor. General debt law keeps a resident head of family's garnishment to 10 percent of disposable earnings.
- $10 — Garnishment ceiling for a resident head of family, share of disposable earnings
- $9/year — Interest on a non-tort judgment unless a contract sets more
Legal protection: A resident head of family keeps more of their wages from garnishment · The hospital's own written financial assistance policy is enforceable on its own terms
What it costs the family: None.
The eligibility facts, as published
- Condition
- any Missouri hospital bill
- Residency
- Missouri
The trap: The protections people mention in Missouri are general, not medical: a resident head of family keeps more of their wages from garnishment, and judgments carry 9 percent interest. Neither of those is a medical-debt rule, and none of it stops a bill being sent to collections.
Where I read this
- RSMo 525.030 — Missouri Revisor of Statutes, read September 10, 2026
- RSMo 408.020 — Missouri Revisor of Statutes, read September 10, 2026
- RSMo 408.040 — Missouri Revisor of Statutes, read September 10, 2026
- ARPA project: Medical Debt Forgiveness — City of St. Louis, read September 10, 2026