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

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Washington program

Reduce your hospital bills (financial assistance)

Washington hospitals must offer financial assistance, including to families with insurance. It can cancel or reduce the part of a hospital bill that insurance leaves you to pay.

What it is

Washington hospitals must offer financial assistance, including to families with insurance. It can cancel or reduce the part of a hospital bill that insurance leaves you to pay.

Washington hospitals must offer financial assistance to eligible patients, including families with insurance.

Eligibility rules
  • State law sets the minimum: full help to 300% of poverty and discounts to 400% at hospitals in the higher statutory tier; Seattle Children’s publishes more.
  • The hospital applies its own family and income definition and can ask about a recent income loss.
  • Separate doctor or outside-provider bills may not be included; ask which accounts the approval covers.
What you get
  • Full or partial cancellation of deductibles, coinsurance and copays on eligible hospital charges.
  • Applies to bills already in collections, once the hospital and collector know about the application.
Which bills
  • Assistance applies to eligible hospital charges. Independently billing doctors and outside clinicians may have separate policies.
  • Tell both the hospital and any collection agency, in writing, that the application is pending and keep proof; the collector’s duty to pause depends on having received that notice.
If you decide to apply
  1. Ask the financial counselor for the application and a list of the bills it can cover.
  2. Send the income information requested and explain any recent change in pay. Keep a copy and the date.
  3. Ask for the decision in writing and how to appeal if something was missed.
After you apply
  • Ask how long an approval lasts and when to reapply; at Seattle Children’s, for example, approvals typically last six months, and the award letter controls the dates.
  • Ask which accounts are covered and whether pharmacy is included; separately billed organizations are often excluded.
  • The counselor confirms the current bands; a hospital’s own pages can disagree at the edges.
Good to know

You can apply with insurance, and Apple Health can sit alongside it; they cover different parts of the bill.

Other hospitals in this guide
  • Providence Sacred Heart: full help through 300% of poverty; 301% to 400% uses an 80% reduction of original charges.
  • Mary Bridge: the current MultiCare schedule was not verified; ask for the current policy naming Mary Bridge.

Federal background: Ask the hospital to reduce your bill (hospital financial assistance).

Official sources
More background and detailed requirements

How this could help

Ask for the hospital’s financial-assistance application, sometimes called charity care. You do not need to be uninsured. Deductibles and coinsurance on eligible hospital charges can qualify.

State law sets minimum discounts, and a hospital may offer more generous help. At hospitals in the higher statutory tier, income up to 300% of the poverty level qualifies for full help with eligible patient responsibility, with discounts through 400%. At other hospitals, the minimum full-help limit is 200%, with discounts through 300%.

What to know before you apply

  • Ask which policy applies to the hospital treating your child. The higher tier includes specified hospital systems and additional statutory hospital categories.
  • Separate doctor or other outside-provider bills may not be included; ask which bills the approval covers.
  • Income timing, family size and sometimes assets affect the decision. A recent income loss should be explained.
  • You can ask even if a bill has already gone to collections. Tell the hospital and collector about the application.

Your next steps

  1. Ask the hospital’s financial counselor for the application and a list of bills it can cover.
  2. Submit requested income information and explain any recent changes. Keep a copy and the date submitted.
  3. Ask for the decision in writing and how to appeal if information was missed.

Policies for the Washington hospitals in this guide

Seattle Children’s: the policy effective November 21, 2025 provides full assistance through 400% of poverty and partial assistance at 401–599%, for eligible services and billing arrangements. There is no asset test. Separate primary-care practices and outside clinicians require the applicable provider policy. Apply through MyChart or financial counseling at 206-987-3333.

Providence Sacred Heart: the December 1, 2025 eastern Washington schedule provides full assistance through 300% of poverty. At 301–400%, the policy uses an 80% reduction of original charges subject to its amounts-generally-billed limit—not an 80% reduction of the remaining insured balance. A separate catastrophic-expense provision can apply. Call 855-229-6466 and check which provider bills are included.

Mary Bridge: this review did not verify the current complete MultiCare hospital-specific schedule or provider attachment. Request the current policy naming Mary Bridge and its application through the financial-assistance contact on the bill. Do not substitute Seattle Children’s or Providence’s limits.

the statutory bands run to 400% of the federal poverty level at a larger system and 300% elsewhere

insured and uninsured patients both qualify

the statute allows an asset adjustment that can reduce a discount in the upper bands

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 income proof, and keep the date you applied.

Your social worker

The hospital's financial counselor screens you and must decide before sending the account out.

The care team

Nothing.

Who decides
The hospital, under state law.
Ask the billing office
“Could you help us apply for hospital financial assistance and check all the bills it could cover?”

How to apply

First step: Ask the hospital’s financial counselor for the application and a list of bills it can cover.

  1. Ask the financial counselor for the charity-care application and the written policy this week.
  2. Apply before the account leaves the hospital, and get the application date in writing.
  3. If a collector is already calling, tell them in writing that a charity application is running.

Official application / program page ↗

Where it starts: Ask the hospital's financial counselor for a charity-care application and for the written policy. Say you are applying, in writing, before any account goes to collection.

What to gather

  • Proof of income
  • Every hospital bill since July 2022
  • Your insurance statements showing what the plan left

How long: Set by each hospital; ask for the decision date in writing.

What a yes looks like

A written decision cancelling or cutting the patient share.

What a no looks like, and the next move

If the no is about income, ask which figure and which household size they used, and appeal in writing.

Watch out

  • Apply before the account goes to collection; the hospital must decide first.
  • Insured patients count: it covers what the plan leaves behind.
  • Some hospitals go further than the law; ask for the hospital's own policy too.

Dates that change this

2026-09-10: The larger-system tier is a system with at least three acute hospitals, or the statute's bed-count and county tests. Being a big hospital is not the test; ask which tier the hospital is in.

The numbers and the rules

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

What it is worth

The whole patient share written off at or under 300% of poverty at a larger system, or 200% elsewhere, with 75% and 50% discounts in the bands above.

  • $300 — Full write-off ceiling at a hospital in a system of three or more acute hospitals
  • $200 — Full write-off ceiling at every other licensed hospital
  • $75 — Discount from 301 to 350 percent of poverty at a larger system
  • $50 — Discount from 351 to 400 percent of poverty at a larger system
  • $75 — Discount from 201 to 250 percent of poverty at every other hospital
  • $50 — Discount from 251 to 300 percent of poverty at every other hospital

Legal protection: Insured patients count: the deductible and coinsurance left by the plan can be written off · The hospital must decide before it sends the account to collection

What it costs the family: Nothing to apply.

The eligibility facts, as published

Income
the statutory bands run to 400% of the federal poverty level at a larger system and 300% elsewhere
Insurance status condition
insured and uninsured patients both qualify
Assets
the statute allows an asset adjustment that can reduce a discount in the upper bands
Care dates
care provided on or after July 1, 2022
Residency
care at a licensed Washington hospital

Decisions this site cannot make: Hospital sponsorship determination

Expect friction on: Getting the written policy out of the hospital

The trap: Ask before the bill goes to collection: the hospital must make its first decision about assistance before it sends the account to collection, and once you have applied a collector must stop while the application or appeal runs. Some hospitals publish better terms than the law requires; Seattle Children's writes the whole balance off to 400% and discounts to 599%.

Where I read this

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