Federal, exists in every state
Ask the hospital to reduce your bill
Hospital financial assistance can reduce or erase eligible bills, including bills left after insurance.
What it is
Hospital financial assistance can reduce or erase eligible bills, including bills left after insurance.
UVM Medical Center's policy includes insured families and checks income and assets. Other hospitals can have different policies. Separately billed clinicians may need a separate review.
Eligibility rules
- Policy PAS1A, effective January 1, 2026, includes UVM Medical Center and all Vermont counties. Ordinary assistance uses both an income test and an asset test.
- The full policy provides free eligible care at or below 250% of poverty. Its ordinary discount band extends through 400%: eligible insured patients receive 40% off the balance after insurance, and eligible uninsured patients receive a further 40% off the amount generally billed.
- The catastrophic branch extends through 600% of poverty when hospital out-of-pocket bills exceed 20% of household income. It reduces the balance to the lesser of 20% of income or $10,000, subject to the full policy's conditions.
- Completed applications have a 30-day processing standard. The collections policy provides a 180-day notification period and prohibits extraordinary collection actions, except certain liens on personal-injury settlement proceeds.
- The 2026 chart uses a strict below-250% boundary and a single 76% discount. Those figures differ from the full policy's at-or-below boundary and 40% figures.
- Under the January 1, 2026 policy, ordinary assistance requires liquid assets below the annual 400%-of-poverty amount for your family size. The primary home, qualifying retirement and pension assets, 529 accounts and specified secondary property are excluded. The catastrophic branch waives that ordinary asset test. Covered facility and included employed-clinician bills qualify; independent clinicians, outside hospitals, research and non-medically-necessary services need separate review.
- An ordinary award covers eligible open balances and six months of future care. Certain qualifying fixed-income disabled or older patients and employees can receive 12-month approvals. A denial appeal is due within 60 days; the policy gives 60 days for an appeal response. Financial Advocacy confirms the covered dates and any written collection hold. A pending request does not automatically pause every collection or court deadline.
- Vermont’s large-facility assistance floor, effective July 1, 2022, includes free medically necessary care through 250% of poverty and at least a 40% reduction above 250% through 400%. A catastrophic route reaches 600% when qualifying bills exceed 20% of income. Under UVM’s 2026 policy, annual amounts for three people are $68,300 at 250%, $109,280 at 400% and $163,920 at 600%.
What you get
- Free eligible care at UVM Medical Center through 250% of the poverty guideline.
- Discounts through 400%, with a separate route for very large bills through 600%.
If you decide to apply
- Ask UVM Financial Advocacy at 802-847-1122 for the financial-assistance application.
- Have current income and asset records, insurance statements and patient bills ready.
UVM Financial Advocacy, 802-847-1122 · Official page ↗
Good to know
The hospital’s full policy and chart differ. Financial Advocacy can provide a written calculation and identify which bills qualify.
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
Federal rules require tax-exempt hospitals to publish financial-assistance policies. The hospital’s policy sets which bills and families it covers.
Ask the hospital financial counselor for the application and the list of providers it covers. A hospital bill and a separately billed physician charge may not have the same assistance policy.
- Ask the hospital financial counselor for an assistance application and a review of your bills.
Before you start
- 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.
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 |
|---|---|---|---|---|
| University of Vermont Children's Hospital (Golisano Children's Hospital) · policy | 250% FPL | 400% FPL | yes | 802-847-1122 |
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