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Requesting Financial Assistance

Federal law requires nonprofit hospitals to establish policies for offering patients financial assistance, such as free or discounted medical services for eligible patients. The policies and how to apply for financial assistance must be in writing and available from both the hospital and on the hospital’s website.

Hospitals often charge an uninsured patient high “retail” prices for services, but charge significantly less for the same service to a health insurer, Medicare, or Medicaid. If you are eligible for financial assistance from a nonprofit hospital, the hospital should not charge you the “retail” price but instead should charge a price similar to what it charges insurance companies, Medicare, and Medicaid. The hospital even has to go back and reduce bills you received even before you established eligibility for financial assistance.

Federal law does not otherwise specify standards for financial assistance, but about half the states have medical debtor protection laws that specify who, based on family income, is eligible for financial assistance and what type of assistance a hospital must offer. For example, the hospital may have to offer an interest-free installment plan, reduced cost medical care, or even free medical care. The hospital’s financial assistance plan will set out exactly the type of financial assistance that it provides to those who are eligible.

In at least some states you can also apply for Medicaid and if you are found eligible, Medicaid will cover retroactively medical bills incurred over the last three months. This retroactive coverage is not available in every state.

Other hospitals or health care providers may agree to reduce bills based on your financial hardship even if not required to do so by federal or state law. Explain your financial situation and that you will pay when you are financially able. You can ask for a payment plan, but do not agree to a payment plan if you cannot afford the payments.

Chapter 8 discusses ways before you incur a medical bill to obtain medical and dental care at reduced prices, such as applying for Medicaid or obtaining low cost dental care from a dental school. But even after you have incurred medical bills, there are charities and other programs that may help pay for some of your medical bills.