CHARITY CARE IS BIGGER THAN MOST CLIENTS REALIZE

Millions of Patients May Qualify for Help with Hospital Bills

Many clients assume financial assistance is only for people with very low incomes. That is not how every hospital's policy works. Federal rules require qualifying tax-exempt hospitals to maintain a written Financial Assistance Policy covering eligibility for free or discounted care. But the actual income limits and other requirements can vary significantly from one hospital to another.

200%

Median income cutoff for free care at nonprofit hospitals.

400%

Median income cutoff for discounted care at nonprofit hospitals.

70.6%

Hospitals offering hardship assistance based on patient income.

20%

Median bill-to-income threshold for hardship assistance.

The Numbers are Bigger than Many People Expect

A national analysis of 2,989 nonprofit hospitals found that income limits for free care ranged from 41% to 600% of the federal poverty guideline. Discounted-care limits ranged from 100% to 1,000%.

The median cutoff was 200% for free care and 400% for discounted care. For a family of four in the 48 contiguous states and D.C., the 2026 federal poverty guideline is $33,000. That means:

$66,000 — 200% of the 2026 guideline

$132,000 — 400% of the 2026 guideline

Those numbers do not mean every hospital uses those exact limits. They show why it is worth checking the hospital's policy before assuming a client will not qualify.

More than $800 Million in Attempted Collections

This is where the issue gets even more significant. A CBS News analysis of IRS data found that more than 400 nonprofit hospitals attempted to collect more than $800 million in one year from patients who, based on the hospitals' own policies, otherwise qualified for charity care.

The investigation examined the nation's roughly 3,000 nonprofit hospitals and found examples of hospitals pursuing payment from patients who appeared to meet their own financial-assistance criteria.

MORE THAN $800 MILLION

Watch Dr. Bill Hennessey on NewsNation’s CUOMO Break Down Hospital Charity Care.

What You Can Tell Your Clients

CMS specifically advises consumers to ask nonprofit hospitals about financial assistance and to locate the hospital's Financial Assistance Policy.

A simple question can start the process:

“Does this hospital have a Financial Assistance Policy, and can you send me the policy and application?”

Then review the policy for:

Income eligibility
Free versus discounted care
Hardship provisions
Requirements for insured patients
Required documentation
Application deadlines
How the hospital handles bills while an application is being reviewed

Don’t Assume the Bill is Final

Dr. Bill Hennessey's healthcare advocacy has focused heavily on helping people understand these kinds of programs and the options that may be available when medical bills become difficult to manage.

The takeaway for agents: Don't assume a client has no options simply because they have insurance or earn more than the federal poverty level. Hospital financial assistance policies can extend much further than many people realize, and the only way to know what may be available is to check the specific hospital's policy.