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

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Texas program

Texas bill and debt protections

Texas gives you an itemized hospital bill and limits what medical-debt collectors can take or threaten.

What it is

Texas gives you an itemized hospital bill and limits what medical-debt collectors can take or threaten.

A large bill does not give a collector unlimited power. Texas requires a plain-language itemized bill before collection and protects certain property. Hospital financial assistance and a legal-aid review can address different parts of the problem.

Who this can help
  • Texas current-wage and homestead protections have legal limits. A legal-aid lawyer can review the property and papers involved.
  • Deposited wages do not have the same protection as current wages. An exemption for wages does not promise that a bank account is safe from a levy.
What you get
  • A plain-language itemized facility bill before collection.
  • Protection against garnishment of current wages for medical debt.
  • Protection for a qualifying homestead and limits on collection threats.
What the rules cover
  • Health and Safety Code chapter 185 requires a plain-language itemized bill before collection, effective September 1, 2023.
  • Debt-collection law prohibits threats of arrest, unauthorized fees and misrepresentation. The usual debt-suit limitation is four years under Civil Practice and Remedies Code 16.004.
  • For a facility covered by this rule, an itemized bill must come with a request for payment after your care and no later than 30 days after the facility receives the insurer’s final payment. The facility cannot pursue collection before complying. Federally qualified health centers are excluded, and a separate doctor’s bill may follow different rules; your counselor can check which bill this is.
If you decide to apply
  1. Ask the hospital billing office for the itemized bill and its financial-assistance application.
  2. Gather bills, insurance explanations, collection letters and their envelopes for the financial counselor.
  3. Ask the counselor about a written collection hold and a legal-aid referral if court papers arrive.

Hospital financial counselor; Texas State Law Library referrals: 512-463-1722 · Official page ↗

What happens next
  • The financial counselor can review assistance separately from checking whether the bill is correct. A collection hold needs written confirmation.
  • Court papers carry their own response deadlines. An expired limitation period is a legal defense to discuss with a lawyer, not a reason to leave the papers unanswered.
Good to know

The four-year limit is generally a deadline to sue, not a date when the debt disappears. A judgment can last longer.

Other details
  • Protection for current wages does not automatically protect money already in a bank account, and a homestead exemption does not protect every asset. Some benefits have separate protections. A hospital injury lien is not the same as a lien on your home for cancer treatment. An old debt or a judgment needs its own legal review, so court papers still need a timely response; your social worker can help find legal aid.
Official sources
Ask your social worker

“Can you help us check the itemized bill, request financial assistance and understand our protections if a collector contacts us?”

Why I’m asking: I want to know what we actually owe and whether we need help with collection papers.

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 itemized bill and the financial-assistance application before paying, keep every collection letter, and answer any lawsuit.

Your social worker

Connects you to the hospital financial counselor and asks for a written collection hold during the assistance review.

The care team

Nothing. Clinicians do not decide bills.

Who decides
The facility must itemize. A court decides any suit. Exemptions apply by law
Ask the billing office
“Can you send the itemized bill and financial-assistance application? Can you hold collection while you review our application?”

How to apply

First step: For any bill you cannot pay, write to the facility asking for the itemized bill and the financial-assistance application. For a collector, keep every letter and call the State Law Library at 512-463-1722 for referrals.

  1. For any bill you cannot pay, write to the facility asking for the itemized bill and the financial-assistance application. For a collector, keep every letter and call the State Law Library at 512-463-1722 for referrals.

Where it starts: Written request to the facility; State Law Library 512-463-1722 for referrals

What to gather

  • Every bill and explanation of benefits
  • Collection letters and envelopes
  • The financial-assistance application

How long: The itemized bill is due before collection begins, tied to final payment by insurance (30 days).

What a yes looks like

An itemized bill you can check line by line, and a collection hold while assistance is reviewed.

What a no looks like, and the next move

A facility that collects without itemizing is breaking the law. Complain to HHSC and get legal aid.

Watch out

  • Wages once deposited in a bank are not protected the same way. Keep bill money separate and ask legal aid before a levy.
  • Four years is the deadline to sue, not an expiry of the debt. A judgment lasts longer. Always answer a lawsuit.
  • Ask for the itemized bill and the financial-assistance application before paying anything.

The numbers and the rules

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

What it is worth

An itemized bill in plain language before any collection (SB 490). Wages cannot be garnished for medical debt. The home is exempt. No hospital lien on a leukemia family's house. A suit must come within four years.

Legal protection: Itemized bill with plain-language descriptions before collection (HSC ch. 185, since 2023-09-01) · Current wages cannot be garnished for medical debt (Const. Art. XVI §28. CPRC 63.004) · Homestead exempt from creditors (Property Code 41.001) · Hospital liens attach only to injury claims with admission within 72 hours (Property Code 55.002) · Debt suit must be filed within four years (CPRC 16.004) · Collectors barred from threats of arrest, unauthorised fees and misrepresentation (Finance Code 392)

What it costs the family: None.

The eligibility facts, as published

Residency
Texas

The trap: Four years is the deadline to sue, not an expiry of the debt. A judgment lasts longer. Always answer a lawsuit.

Where I read this

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