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

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Ohio program

Free basic hospital care at low income (HCAP)

HCAP gives eligible Ohio residents free basic hospital care at participating hospitals when they are not on Medicaid.

What it is

HCAP gives eligible Ohio residents free basic hospital care at participating hospitals when they are not on Medicaid.

HCAP reviews qualifying basic hospital charges under Ohio’s state rules. The hospital’s own assistance policy is a separate review and may help with insured balances, unusually large bills or services HCAP excludes. Your social worker can help identify the correct policy for the hospital, clinician and dates of care.

Eligibility rules
  • You must be an Ohio resident with income at or below 100% of poverty and not a Medicaid recipient.
  • Nearly every Ohio hospital takes part.
  • The line is the poverty level itself: about $2,277 a month for three people and $2,750 for four (2026).
What you get
  • A zero hospital charge for qualifying basic hospital care.
  • A separate discussion of the hospital’s own financial-assistance policy, which may help with insured balances or costs outside HCAP under that hospital’s rules.
What this covers
  • HCAP concerns the hospital account. Independently billing doctors follow their own financial-assistance policies.
  • The dates of care and Medicaid coverage matter when a hospital reviews earlier bills.
If you decide to apply
  1. Your social worker can help the hospital’s financial-assistance team decide whether an HCAP review fits these bills.
  2. Have income records for the dates of care, insurance details and the bills ready.
  3. Ask which bills belong to the hospital and which come from separate medical groups.

The hospital's billing or financial-assistance office · Official page ↗

After you apply
  • A written approval identifies the hospital charges receiving assistance.
  • The hospital checks income and Medicaid coverage for the dates of care, including whether older bills can be included. Your social worker can help confirm the HCAP application deadline, the income records needed, the hospital’s decision time and its written review process. HCAP and the hospital’s broader assistance program can use different dates.
  • A timely financial-assistance application can stop extraordinary collection actions while the hospital reviews it under applicable rules. Ordinary bills or calls may follow different rules, and some hospitals pause more. The financial counselor can confirm in writing what is paused and which account or deadline is affected.
  • Federal nonprofit-hospital rules generally allow at least 120 days after the first post-discharge bill before extraordinary collection actions and a 240-day assistance-application period. These are separate from HCAP deadlines and do not establish a universal pause during an appeal.
Good to know

Transplantation and related services are excluded from HCAP. The hospital's separate financial-assistance policy may still matter.

Other details
  • HCAP is not a statewide medical-debt buyback application.
  • HCAP is one form of hospital-bill help, not a general medical-debt cancellation law. Hospital policies and legal protections can differ by bill. Your social worker can help check the current rules and connect you with legal help before a collection or court deadline passes.
  • Hospitals must post HCAP notices in admissions areas, the business office and emergency room.
Official sources
Ask your social worker

“Could HCAP or the hospital's own policy reduce our bills, and which charges would remain? Could you help us decide what to request?”

Why I’m asking: I want to understand which treatment bills the hospital can forgive and which need a separate review.

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 HCAP application by name and give your income for the dates of care.

Your social worker

The financial counselor runs HCAP and the hospital's own policy together.

The care team

Records and letters when the application asks for them.

Who decides
The hospital decides HCAP. The Ohio Department of Medicaid oversees the program.
Ask the billing office
“Our income is at or under the poverty line and my child is not on Medicaid. Can we apply for HCAP for the hospital bills? And which doctors bill separately?”

How to apply

First step: Ask the billing office for the HCAP application before paying anything. At Nationwide Children's and University Hospitals it is part of the financial-assistance form.

  1. Ask billing for the HCAP application before paying any hospital bill.

Official application / program page ↗

Where it starts: Ask the hospital billing or financial-assistance office for the HCAP application (Nationwide Children's financial-assistance page; University Hospitals' HCAP application)

What to gather

  • Income for the service dates
  • Proof of Ohio residence
  • The insurance statement showing what it paid (the explanation of benefits)

How long: The hospital runs it; no timeline is published.

What a yes looks like

A written HCAP decision and a zero balance on the hospital account.

What a no looks like, and the next move

Ask which part failed: income, Ohio residence or Medicaid status. Then apply under the hospital's own policy.

Watch out

  • A child on Medicaid is left out. Apply for Healthy Start first; HCAP covers the months before it starts.
  • Hospital bill only. Doctors who bill separately have their own policies.
  • Transplant care, and the services that go with it, are left out.
  • HCAP is hospital assistance, not a statewide debt-buyback application. Transplantation and associated services are excluded; ask the hospital to check its separate financial-assistance policy.

Dates that change this

2025-05-06: HB257 was introduced as a proposal. Its enactment status, effective date and account scope remain unresolved as of September 21, 2026; no proposed provision is presented as current law. (not yet confirmed against the final rule)

The numbers and the rules

The arcane layer, kept on purpose. Checked September 10, 2026.

What it is worth

Free basic hospital care at or under 100% of the poverty line for an Ohio resident not on Medicaid. Hospital bill only; transplant care left out.

  • $100 (at or below; 2026 monthly equivalents our arithmetic: $1,803 (2), $2,277 (3), $2,750 (4), $3,223 (5), $3,697 (6)) — Income ceiling

Legal protection: Basic, medically necessary hospital-level services free of charge at HCAP hospitals for Ohio residents at or below the poverty line who are not Medicaid recipients · Insurance and third parties are billed first; being insured does not by itself exclude an application

What it costs the family: None for the hospital services it covers.

The eligibility facts, as published

Residency
Ohio resident
Income
at or below the federal poverty line
Not medicaid
not a Medicaid recipient
Hospitals
each hospital receiving payment under ORC Chapter 5168 (the package did not quote a statement that every Ohio hospital does)
Exclusions
transplantation services and services associated with transplantation
Scope
hospital bill only (Nationwide Children's)
Medical debt law
HB257 enactment, effective date and transition provisions were not established as of September 21, 2026. No proposed protection or categorical absence of other Ohio law is asserted.

Decisions this site cannot make: Hospital HCAP determination

Expect friction on: Hospital-administered · Service-date income

The trap: Hospital bill only. Doctors who bill separately are outside it, and a transplant is left out. Ask the billing office for the HCAP application by name.

Where I read this

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