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

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Virginia program

Hospital discounts and protection from medical debt

Hospital assistance can reduce eligible bills, and Virginia law limits certain medical-debt collection practices.

What it is

Hospital assistance can reduce eligible bills, and Virginia law limits certain medical-debt collection practices.

There is no single statewide free-care income limit. Your hospital’s policy decides discounts and may also help insured families. Medical-debt protections can give you time to sort out a bill.

Eligibility rules
  • Virginia hospitals must make reasonable efforts to screen uninsured patients for Medicaid or financial assistance. An uninsured patient found eligible for assistance must receive a written payment-plan offer that considers ability to pay. The hospital checks the applicable patient and responsible-party definitions.
  • Under Virginia's medical-debt law, a hospital cannot add interest or late fees for 90 days after the final bill is due, cannot charge more than 3% a year after that, and cannot sue or send you to collections for 120 days. It must warn you in writing 30 days before any of those steps.
What you get
  • Reasonable efforts to screen uninsured patients for coverage or hospital assistance.
  • For debts covered by the interest rule, a 90-day interest and late-fee pause and a combined 3% annual ceiling.
  • For covered debts, a 120-day wait before extraordinary collection and at least 30 days’ written warning.
What the rules cover
  • Virginia does not set a uniform free-care percentage or discount ladder. The hospital’s written policy controls.
  • Garnishment protection depends on qualifying under the assistance policy.
  • Virginia separately prohibits the medical-debt reporting described in its credit-reporting law. That does not guarantee removal of every old credit entry or protect a general credit-card balance used to pay a medical bill.
If you decide to apply
  1. Ask the hospital financial counselor in writing for the assistance policy, screening and application.
  2. Bring bills and income documents. Ask which invoice is final and whether collection can pause during the review.

The hospital for assistance; the state consumer protection route for the debt rules · Official page ↗

If you decide to apply
  • A hospital generally has three years from the final bill's due date to sue over it. If court papers arrive, the response deadline on them still applies; legal aid can check the bill.
  • The 90-day interest and late-fee pause and 120-day extraordinary-collection wait run from the final invoice’s due date. Written warning comes at least 30 days before an extraordinary action. Excess-payment refunds have a separate 60-day clock after the excess is determined. The billing counselor checks which debt and creditor each rule covers.
  • Where federal nonprofit-hospital rules apply, they restrict extraordinary collection under their assistance-application procedures. They do not freeze every ordinary statement or every appeal. A written collection hold can be discussed with the hospital; court notices retain their own response dates.
  • CHKD decides within 15 business days of a complete application. Inova accepts applications for a year after the first bill, decides within about 30 days, and allows 45 days to appeal.
  • A bill review can compare itemized charges with each insurer’s explanation and any assistance award. A payment plan changes payment timing, not necessarily the balance. Any collection hold and remaining payment terms should be confirmed in writing.
Good to know

Different deadlines start on different dates. Your billing counselor can check the final invoice, creditor and hospital policy; these rules do not pause every collection step.

Other details
  • Insured-patient eligibility, separate physician bills and hardship relief vary by hospital.
  • CHKD: full help up to 175% of poverty, then discounts of 75% to 250%, 50% to 325% and 25% to 400%. Insured families can apply; the counselor checks how your plan's contract affects it.
  • Inova: full help up to 400% of poverty. Above that, a bill larger than 15% of your income can be capped at 15%. You usually need to have lived in Virginia for 30 days.
  • Carilion: full help below 300% of poverty with savings under $25,000, partial help below 500% with savings under $100,000. A separate catastrophic branch applies when bills exceed 20% of your yearly income plus savings.
  • CHKD approval can last up to one year from the decision, with review for major financial changes. Inova’s period ends on the last day of the 12th month after the first eligible service. Carilion reassesses later services after more than 365 days or a material financial change. Approval does not automatically cover independent doctor, laboratory, transport or other separately billed services.
  • UVA Charlottesville and VCU’s financial counselors confirm their current income bands, insured-patient terms, approval periods and covered-doctor lists. Naval Medical Center Portsmouth uses a military coverage route. Its benefits counselor can check TRICARE and any separately billed civilian services.
  • CHKD has a separate hardship branch above 400% when unpaid medical bills from the prior six months exceed 5% of combined family income. It describes a 20% adjustment to current balances, subject to its policy and amount-generally-billed limit. After Medicaid approval, CHKD can provide free help for qualifying outstanding balances within three months before Medicaid’s effective date. That is hospital assistance, not Medicaid-paid retroactivity.
  • Your selected hospital does not establish where later treatment will happen. If another hospital or out-of-state treatment is considered, your social worker can check its assistance policy, network, approvals and travel rules separately.

Federal background: Hospital financial assistance · Checking and negotiating medical bills

Official sources
Ask your social worker

“Could the hospital reduce our bill under its assistance policy? Could you help us apply, identify any separate doctor bills, and understand collection deadlines?”

Why I’m asking: I want to know what we really owe before agreeing to a payment plan.

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 and keep every letter with its date.

Your social worker

The financial counsellor runs the screening and gives you the policy and the application.

The care team

Records and letters when the application asks for them.

Who decides
The hospital, and a court if a collector sues
Ask the billing office
“Please screen us for financial assistance and send the written policy and application. Which invoice is the final one, and what is its due date? Please hold collection while this is decided.”

How to apply

First step: Write to the billing office asking for the financial assistance screening, the written policy and the application, and for collection to be held meanwhile.

  1. Ask the billing office in writing for the financial assistance screening and the written policy.
  2. Ask which invoice is the final one and what its due date is, then diary 90 and 120 days.
  3. Ask for an itemised bill before paying anything.

Official application / program page ↗

Where it starts: Ask the financial counsellor in writing for the screening, the written policy and the application, and for a hold on collection while it is decided.

What to gather

  • Every statement with its date
  • Any collection letter
  • This month's income

How long: The 90-day interest and late-fee pause and 120-day extraordinary-collection wait run from the final invoice’s due date. Written warning comes at least 30 days before an extraordinary action. Excess-payment refunds have a separate 60-day clock after the excess is determined. The billing counselor checks which debt and creditor each rule covers.

What a yes looks like

A written assistance decision and, where it applies, a payment plan set by what you can afford.

What a no looks like, and the next move

A refusal to screen or a collection letter inside the windows. That is a consumer protection complaint; keep the dates.

Watch out

  • The 90-day interest and late-fee pause and 120-day extraordinary-collection wait run from the final invoice’s due date. Written warning comes at least 30 days before an extraordinary action. Excess-payment refunds have a separate 60-day clock after the excess is determined. The billing counselor checks which debt and creditor each rule covers.
  • Virginia has no statewide free-care percentage; the hospital's own policy sets the discount.
  • The garnishment protection applies to someone who qualifies under the assistance policy, so getting screened is what unlocks it.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

For covered debts and creditors: a 90-day interest/late-fee pause and combined 3% annual cap; a 120-day extraordinary-collection wait and at least 30 days’ advance written warning.

  • $90 — Days after final-invoice due date before interest/late fees for covered large-facility or debt-buyer debt
  • $3 — Combined annual interest/late-fee cap for creditors covered by that subsection
  • $120 — Days after final-invoice due date before extraordinary collection for covered debt
  • $30 — Minimum advance written warning before extraordinary collection
  • $3 — General medical-debt lawsuit limitation, with payment-plan and Medicaid-payment qualifications

Legal protection: Reasonable efforts to screen uninsured patients for Medicaid and hospital financial assistance · A written payment-plan offer considering ability to pay for an uninsured patient found eligible for assistance · No arrest, body attachment, foreclosure on a home, or lien on personal property to collect medical debt · No wage garnishment against anyone who qualifies under the financial assistance policy that applies to the debt · No reporting of medical debt collection to a credit bureau · Applicable reasonable eligibility efforts before extraordinary collection

What it costs the family: None to ask.

The eligibility facts, as published

Screening
Reasonable efforts to screen uninsured patients for Medicaid and hospital financial assistance
Patient for a minor
the financially responsible adult
Debt protections
Since July 1, 2026, the Medical Debt Protection Act has different rules for different creditors. Its 90-day interest/late-fee pause and 3% annual cap apply to large health care facilities and medical debt buyers. Large facilities include Virginia Department of Health-licensed hospitals and clinics under their licenses, plus outpatient practices with at least $20 million in annual revenue. Other provisions, including the 120-day extraordinary-collection wait, apply more broadly to medical creditors and collectors; the entire Act is not limited to large facilities.
Not covered
no statewide free-care percentage, no uniform discount ladder, and no verified state debt buy-back was found

The trap: The 90-day interest and late-fee pause and 120-day extraordinary-collection wait run from the final invoice’s due date. Written warning comes at least 30 days before an extraordinary action. Excess-payment refunds have a separate 60-day clock after the excess is determined. The billing counselor checks which debt and creditor each rule covers.

Where I read this

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