← The Ledger

You can find out if your care is free before you walk in.

Most people learn about hospital financial assistance after a bill has gone to collections. It does not have to work that way — and by law, it is not supposed to.

Every 501(c)(3) hospital must have a written financial assistance policy

Federal law (26 U.S.C. §501(r) — a condition of the tax exemption they hold) requires each one to have a written policy saying who qualifies for free or discounted care, to publicise it, and to tell patients it exists. And before taking certain extraordinary collection actions — lawsuits, liens, wage garnishment, reporting to credit agencies, selling the debt — the hospital must make reasonable efforts to determine whether you qualify for that assistance. The law does not set the income line — each hospital chooses its own.

The line is different at every hospital — and each one files its own line with the IRS every year. That is the number we publish.

Look up your hospital’s income line →

What the numbers mean

Policies are written as a percentage of the federal poverty level (FPL). In 2026 the poverty line is $15,960 for one person and $33,000 for a family of four, in the 48 contiguous states.

So a hospital offering free care at “200% of FPL” covers a family of four earning up to about $66,000. One offering free care at 100% covers that same family only up to $33,000. Across the hospitals we hold, the median free-care line is 200% of FPL and the median discount line is 400% — but they run all the way from 40% to 600%, which is exactly why it is worth checking yours.

Source: HHS 2026 Poverty Guidelines. Hospital thresholds come from each hospital’s own IRS filing for the year shown.

How to ask — before treatment, not after

1
Ask by name. Call the hospital’s billing or patient financial services number and use the exact phrase. Vague questions get vague answers.
“I’d like to apply for financial assistance under your charity care policy. Can you send me the application and tell me the income limits?”
2
Ask before scheduled care. You can apply ahead of a planned procedure. You do not have to wait for a bill, and you do not have to be in collections.
3
Ask again even if a bill already exists. Federal rules keep the application period open through at least the 240th day after your first post-discharge billing statement, and longer in some circumstances — that is a floor, not a courtesy — and assistance can be applied to a bill already sent.
4
Get it in writing. Request the written determination. If you are denied, ask which criterion you failed and whether there is an appeal.
5
Bring the filing. Every hospital page on this site links to that hospital’s own IRS filing, showing the income line it reported. It is a reasonable thing to reference.

The cost of not asking

This is the part that rarely gets said plainly. Someone who avoids care because they fear the bill does not stop being sick. Diabetes left unmanaged for two years does not stay a prescription problem — it becomes an emergency admission, a wound that will not heal, a procedure. Care that could have cost a few hundred dollars becomes tens or hundreds of thousands, and by then the person is sicker and poorer than when they first hesitated.

Charity care that appears only after collections is help arriving at the worst possible moment, to someone already frightened and already worse off. Help offered at the front door is a different thing entirely. A hospital’s income line is public, filed, and knowable in advance. That is the whole reason we put it on every page.

If you are avoiding care over cost right now: ask for the financial assistance application before you cancel the appointment. Ask at any hospital, including one you have never been to. The answer is free and the application costs nothing.

Honest limits

Find your hospital’s income line →