Hospital Charity Care: Free Medical Care You Didn't Know About

What Is Hospital Charity Care?

Hospital charity care is financial assistance provided by hospitals to patients who cannot afford to pay their medical bills. Nonprofit hospitals, which make up roughly 60% of all hospitals in the United States, are required under IRS Section 501(r) to maintain a financial assistance policy and make it available to patients. Despite this requirement, billions of dollars in charity care go unclaimed every year because patients do not know it exists.

Who Qualifies for Charity Care?

Qualification varies by hospital, but most nonprofit hospitals provide full charity care (100% of the bill covered) for patients with household income at or below 200% of the Federal Poverty Level. For 2025, that threshold is approximately $31,200 for an individual and $64,400 for a family of four. Many hospitals extend partial discounts to patients earning up to 300-400% of the Federal Poverty Level.

How to Find Out If Your Hospital Is Nonprofit

Most major hospital systems are nonprofit organizations. You can verify a hospital's tax status by searching for it on the IRS Tax Exempt Organization Search tool. You can also check the hospital's annual Form 990, which is publicly available and includes information about their charity care policies and community benefit spending.

How to Apply for Charity Care

Start by contacting the hospital's Patient Financial Services or Financial Counseling department. Ask for the Financial Assistance Application. This form will ask for proof of income (pay stubs, tax returns), proof of assets (bank statements), household size, and insurance status. Most hospitals accept applications within 240 days of the first billing statement after discharge.

What If You Already Paid?

If you already paid a bill and later discover you would have qualified for charity care, you may be able to get a retroactive adjustment. Many hospitals will review prior payments if you submit a financial assistance application. Some states require hospitals to refund payments that exceed what the patient would have owed under the charity care policy.

State Laws That Help You

Several states have enacted additional charity care protections. Washington requires hospitals to provide free care to patients under 300% FPL. California mandates that hospitals screen emergency patients for financial assistance eligibility. New York requires hospitals to offer financial assistance up to 300% FPL. Colorado's Hospital Discounted Care program provides state-level protections. Check your state's specific requirements.

Nonprofit Hospital Obligations Under IRS 501(r)

The IRS requires nonprofit hospitals to establish a written financial assistance policy, widely publicize the policy in the community, conduct a community health needs assessment every three years, limit charges for financial-assistance-eligible patients to amounts generally billed to insured patients, and refrain from extraordinary collection actions before making reasonable efforts to determine eligibility.

How BillDelete Helps with Charity Care

BillDelete generates a customized financial hardship application letter that references your hospital's specific charity care obligations, cites relevant IRS 501(r) requirements, and presents your financial situation in the most compelling way. The letter is professionally formatted and ready to submit alongside the hospital's financial assistance application.

Do Not Leave Money on the Table

If you are struggling to pay a medical bill from a nonprofit hospital, charity care may cover some or all of the charges. The application process is straightforward, and hospitals are legally obligated to consider your request. Apply as soon as possible to avoid collection activity while your application is reviewed.