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

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Pennsylvania program

Your rights on a Pennsylvania hospital bill

You have a right to understand your Pennsylvania hospital bill and hear about financial help. Assistance depends on the hospital’s policy and applicable protections.

What it is

You have a right to understand your Pennsylvania hospital bill and hear about financial help. Assistance depends on the hospital’s policy and applicable protections.

Your hospital may reduce eligible bills, including some balances after insurance. Your social worker can compare your household income with its policy and check the actual bills, assets and medical groups. The financial counselor can explain help at your treating hospital, including treatment outside Pennsylvania.

Eligibility rules
  • The patient-rights regulation applies to Pennsylvania hospital patients. Nonprofit hospital financial assistance follows federal 501(r) and the hospital's own policy.
  • A hospital may offer help to insured patients with remaining bills, depending on its policy. The financial counselor reviews the applicable rules.
  • Your hospital’s current policy sets the assistance described here. The financial counselor can check that policy alongside current Pennsylvania legal requirements, including any new statewide protections that apply to your bill.
What you get
  • A detailed explanation of the hospital bill.
  • Information and counseling about known financial help.
  • A review under the nonprofit hospital's financial-assistance policy.
What the help includes
  • State rules give you the right to see and have explained every charge on a hospital bill.
  • The hospital also has to tell you about financial help it knows of.
  • A financial-assistance decision may reduce qualifying charges. An itemized-bill request alone does not cancel them.
  • UPMC’s policy effective September 27, 2025 offers full help at or below 300% of poverty when the other conditions are met. Its usual above-300%-through-400% discount is for uninsured accounts; insured hardship review is discretionary. All transplant-related services are excluded. Assets, service area and the covered hospital or medical group also matter.
  • Penn State Health’s February 2026 policy offers full help at or below 300% of poverty, subject to its other tests. Medical debt above annual income can support discretionary catastrophic review. Approval generally lasts one year, subject to changes and reassessment. Four Diamonds has separate enrollment rules.
If you decide to apply
  1. Ask the billing office in writing for an itemized explanation and the financial-assistance policy.
  2. Bring each bill and its insurance explanation of benefits to the financial counselor.
  3. Ask which charges and medical groups the policy covers before deciding how to handle the balance.

The hospital billing office or financial counselor · Official page ↗

After you ask
  • The billing office can provide the detailed explanation and assistance application. Each hospital sets its financial-assistance process.
  • A refusal to honor the state patient rights can be raised with the Department of Health.
Good to know

A hospital discount does not automatically cover every separate doctor’s bill. The counselor can check which bills and services the policy includes.

Other details
  • An account hold and a court response are separate matters. A financial-assistance request or complaint does not replace the response required by legal papers. Your legal adviser can check that deadline.
  • There is no federal ban on medical debt appearing on your credit report right now. Ask the hospital what its own policy is before a bill goes to a collector.
  • In Pennsylvania a hospital cannot take an ordinary medical debt out of your paycheck. That does not stop a lawsuit or a collection agency, and money already in the bank is not protected the same way.
  • A nonprofit hospital cannot sue you or send the bill to collections for at least 120 days after the first bill, and it must accept a financial-assistance application for at least 240 days. Ask the counselor to put a hold on the account while your application is reviewed.
  • Your legal adviser can check any interest charged and the contract or law supporting it. Pennsylvania’s general 6% legal interest rate is not a universal cap on every medical bill or financing agreement.

Federal background: Nonprofit hospital financial assistance.

Official sources
Ask your social worker

“If we receive a hospital bill, could you review the charges and financial-assistance policy with us? What could be reduced, which bills would remain, and could you help with the application?”

Why I’m asking: I want to understand what we owe before treating the whole hospital balance as final.

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 for the itemized explanation and the financial assistance policy before paying.

Your social worker

The hospital financial counselor checks every resource and hands you the application.

The care team

Records and letters when the application asks for them.

Who decides
The hospital billing office; the state Department of Health on complaint.
Ask the billing office
“Please send an itemized explanation of this bill and your financial assistance application, and tell me every resource you know of that could cover it.”

How to apply

First step: Write to the billing office for the itemized explanation and the financial assistance application.

  1. Ask for an itemized bill and the financial assistance application before paying anything.
  2. Ask the financial counselor about all known resources (MA, PH95, charity care).

Where it starts: Ask the billing office in writing for the itemized explanation and the financial assistance policy.

What to gather

  • Every bill and statement
  • Insurance explanations of benefits

How long: On request.

What a yes looks like

An itemized bill and a financial assistance application in hand.

What a no looks like, and the next move

Refusal: complain to the state Department of Health under the patient-rights regulation.

Watch out

  • No state income limit for hospital help exists; a bill to set one (HB 79) is pending.
  • Pennsylvania has no ban on reporting medical debt to credit bureaus; ask the hospital for its policy before a bill goes to collections.

If they say no, quote this: Patient right to a detailed bill and information on financial resources: 28 Pa. Code §103.22. Wage attachment bar: 42 Pa.C.S. §8127. Federal nonprofit charity-care rule: IRC 501(r).

The numbers and the rules

The arcane layer, kept on purpose. Checked September 9, 2026.

What it is worth

The right to examine the bill, get a detailed explanation, and be told about known financial help; federal charity care at nonprofit hospitals.

Legal protection: The patient has the right to examine and receive a detailed explanation of the bill (28 Pa. Code §103.22(b)(18)) · Right to information and counseling on the availability of known financial resources (§103.22(b)(19)) · Wages held by the employer are exempt from attachment, execution or other process, with statutory exceptions (42 Pa.C.S. §8127)

What it costs the family: None.

The eligibility facts, as published

Scope
Pennsylvania hospital patients
State charity law
none found; HB 79 pending
Credit reporting ban
none found
Garnishment
employer-held wages exempt with exceptions; complete exception text not retained

The trap: Expecting a state income limit. A bill to set one (HB 79 of 2025-26) was sent to a Senate committee on May 22, 2025 and has not passed. Pittsburgh's 2025 medical-debt purchase could not be applied for.

Where I read this

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