Federal, exists in every state
Ask the hospital to reduce your bill
Hospital financial assistance can reduce or eliminate eligible patient bills, including some bills left after insurance.
What it is
Hospital financial assistance can reduce or eliminate eligible patient bills, including some bills left after insurance.
Treatment bills can remain after insurance pays. Tax-exempt hospitals must publish financial-assistance policies, and each hospital sets its application requirements. A counselor can review current income and identify which hospital and physician bills qualify.
Eligibility rules
- Federal financial-assistance policy requirements apply to tax-exempt hospitals. Hospital ownership and the billed entity matter.
- Texas hospitals use different income schedules, residence rules and exceptions. A statewide percentage does not establish your hospital’s award.
- At a tax-exempt hospital, the application period runs through at least 240 days after the first post-discharge bill. A hospital policy can allow longer.
What you get
- A reduction or cancellation of eligible hospital balances.
- A written explanation of which accounts qualify.
What coverage includes
- The counselor can check balances left after insurance and whether earlier paid accounts qualify.
If you decide to apply
- Ask the hospital financial counselor for the assistance application and the list of covered doctors.
- Bring current income records, insurance statements and each bill you want reviewed.
After you apply
- Ask for a written decision and written confirmation of collection handling during review.
- Federal rules bar extraordinary collection actions for at least 120 days after the first post-discharge bill. An assistance application can also limit collection action during review.
- If a timely application is approved after you paid, amounts above your assistance-adjusted bill are refunded when the excess is $5 or more.
Good to know
A hospital and an independently billing doctor can use different policies. A payment plan changes timing, so the assistance decision matters before agreeing to payments.
Other details
- Texas requires covered facilities to provide an itemized bill before collection. The medical-debt card explains that separate protection.
Official sources
“Could you help us apply for the hospital's financial assistance and check which bills it covers?”
Why I’m asking: I want the hospital to check our current income and patient bills before we agree to a payment plan.
More background and detailed requirements
How this works
Treatment bills can remain after insurance pays. Tax-exempt hospitals must publish financial-assistance policies, and each hospital sets its application requirements. A counselor can review current income and identify which hospital and physician bills qualify.
- A reduction or cancellation of eligible hospital balances.
- A written explanation of which accounts qualify.
- Ask the hospital financial counselor for the assistance application and the list of covered doctors.
- Bring current income records, insurance statements and each bill you want reviewed.
Eligibility rules
- Federal financial-assistance policy requirements apply to tax-exempt hospitals. Hospital ownership and the billed entity matter.
- Texas hospitals use different income schedules, residence rules and exceptions. A statewide percentage does not establish your hospital’s award.
What coverage includes
- The counselor can check balances left after insurance and whether earlier paid accounts qualify.
After you apply
- Ask for a written decision and written confirmation of collection handling during review.
Other details
- Texas requires covered facilities to provide an itemized bill before collection. The medical-debt card explains that separate protection.
Request an assistance review even if you have insurance or have already paid some of the bill.
Ask for written confirmation of how collection activity will be handled while your application is reviewed.
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 |
|---|---|---|---|---|
| Texas Children's Hospital—Texas Medical Center · policy | 250% FPL | 400% FPL | yes | 832-824-5505 |
| Cook Children's Medical Center · policy | 400% FPL | 500% FPL | yes | 682-885-2965 option 3 |
| Children's Medical Center Dallas · policy | 200% FPL | 400% FPL | yes | 214-456-2455 |
| Driscoll Children's Hospital · policy | unknown | 500% FPL | yes | 361-694-4758 |
| The University of Texas MD Anderson Cancer Center—Children's Cancer Hospital · policy | 400% FPL | unknown | yes | 844-294-4322 |
| Dell Children's Medical Center of Central Texas · policy | 250% FPL | 400% FPL | yes | 800-749-7624 |
| Baylor Scott & White McLane Children's Medical Center · policy | 200% FPL | 500% FPL | yes | 800-994-0371 |
| CHRISTUS Children's · policy | 300% FPL | 400% FPL | yes | 800-877-8623 |
| El Paso Children's Hospital · policy | unknown | 400% FPL | yes | 915-242-8377 |
| Covenant Children's Hospital · policy | 200% FPL | unknown | yes | 855-229-6466 |
| UMC Children's Hospital / UMC Health System · policy | unknown | unknown | no | 806-761-0842 |
| University Health—Women's & Children's Hospital | unknown | 250% FPL | unknown | 210-358-3350 |
| UTMB Health—John Sealy Hospital / Children's services | 400% FPL | unknown | unknown | 409-772-6464 |
| Medical City Children's Hospital | unknown | unknown | unknown | 866-656-8769 |
| Methodist Children's Hospital · policy | unknown | 500% FPL | unknown | 866-391-2019 |
| Texas Tech Physicians — Amarillo | unknown | unknown | unknown | 806-414-9608 |
| Children's Memorial Hermann Hospital / UTHealth Houston | unknown | unknown | unknown | 713-338-5502 |
| Vannie E. Cook Jr. Children's Cancer and Hematology Clinic | unknown | unknown | unknown | unknown |
| Brooke Army Medical Center · policy | unknown | unknown | no | unknown |
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