Most nonprofit hospitals are required to offer financial assistance — and many people who qualify never apply because they don’t know it exists. Under IRS Section 501(r), a nonprofit (501(c)(3)) hospital must maintain a written Financial Assistance Policy (FAP) covering emergency and medically necessary care, must publicize it, must limit what FAP-eligible patients are charged, and generally must check your eligibility before taking extraordinary collection actions.
Who qualifies
Eligibility is usually based on household income relative to the Federal Poverty Level (FPL). Thresholds and discounts vary by hospital — some give free care below one income level and discounted care on a sliding scale above it. Ask for the policy to see the exact cutoffs; many hospitals also consider you presumptively eligible if you’re already on means-tested programs (Medicaid, SNAP, etc.).
The letter
[Your full name]
[Your address]
[City, State ZIP]
[Phone] | [Email]
[Date]
[Hospital - Financial Assistance / Patient Financial Services]
[Address]
Re: Request for financial assistance (charity care) policy and application
Patient: [Name, date of birth]
Account / Statement number(s): [numbers]
Date(s) of service: [dates]
To Patient Financial Services:
I am requesting a copy of your Financial Assistance Policy (FAP), the plain-
language summary, and the application form, and I am applying for financial
assistance for the account(s) above.
My household: [number] people. Approximate annual household income: $[amount].
[Optional: I currently receive [Medicaid / SNAP / other], which may make me
presumptively eligible.]
Please let me know what documentation you need (for example, proof of income or
tax return) and the deadline to apply. While my application is pending, please
hold collection activity and any extraordinary collection actions on these
accounts, as your obligations under IRS Section 501(r) provide.
Please confirm receipt and the expected decision date. Thank you for your help.
Sincerely,
[Your signature]
[Your printed name]
How to send it
Send to the hospital’s financial assistance / patient financial services office, and apply as early as possible — many hospitals accept applications even after a bill is issued, sometimes for 240 days after the first post-discharge bill, but policies vary. Keep copies and ask for written confirmation.
Notes. 501(r) limits apply to nonprofit hospitals; for-profit and public hospitals may still offer assistance but aren’t bound by the same federal rule — ask anyway. Free help applying exists: the nonprofit Dollar For (dollarfor.org) helps patients find and file hospital charity-care applications. This is general information, not legal or financial advice; income thresholds and deadlines vary by hospital and state.