How to Negotiate Medical Bills — Save 30-70% on Hospital and Doctor Bills

Medical debt is the leading cause of bankruptcy in the United States, and it does not discriminate by income level. Over 100 million Americans carry some form of medical debt, and an estimated $88 billion in medical bills sits in collections according to the Consumer Financial Protection Bureau. A single hospital stay can generate a bill of $10,000 to $50,000 or more, and even routine procedures often produce charges that catch patients off guard.

But here is something that hospitals and billing departments do not advertise: most medical bills are negotiable. The "sticker price" on your hospital bill is not a fixed number — it is a starting point. Hospitals routinely accept 40-60% of what they bill from Medicare, negotiate different rates with every insurance company, and offer steep discounts to patients who simply ask. The difference between patients who pay full price and those who save thousands comes down to knowing the right steps and the right words to use.

This guide walks you through every strategy available for reducing medical bills after you have already received them. Whether you owe $500 for a doctor visit or $50,000 for a hospital stay, these techniques work. For information on managing healthcare costs more broadly, including preventive strategies and price comparison tools, see our complete healthcare costs resource center. If you are dealing with an urgent care bill without insurance, our dedicated guide covers specific cost breakdowns and savings strategies for those visits.

Why Most Medical Bills Are Negotiable

Before diving into tactics, it helps to understand why medical bills are so inflated in the first place — and why providers are almost always willing to accept less than the billed amount.

Hospitals set their prices using something called a "chargemaster" — an internal price list that assigns a dollar amount to every service, supply, and procedure. These chargemaster rates have no connection to the actual cost of delivering care. A bag of saline solution that costs the hospital $1-$5 might appear on your bill at $100-$800. An aspirin tablet that costs pennies is routinely billed at $25-$50. The chargemaster exists primarily as a negotiating ceiling — the highest amount the hospital could theoretically collect.

In practice, almost nobody pays chargemaster rates. Medicare pays roughly 40-60% of what hospitals charge on average. Medicaid pays even less — typically 30-50% of billed charges. Private insurance companies negotiate their own rates, usually landing at 50-80% of the chargemaster price. The only people who receive bills at the full chargemaster rate are uninsured patients and insured patients with out-of-network charges — precisely the people least able to afford them.

This pricing structure means there is enormous room for negotiation. When you ask a hospital to reduce your bill, you are not asking for charity — you are asking to pay a rate closer to what every other payer in the system already pays. Hospitals know this, billing departments expect it, and the vast majority will work with you once you demonstrate that you understand how the system works.

Step 1: Request an Itemized Bill

The single most important first step when you receive any medical bill is to request a fully itemized statement. The summary bill that arrives in your mailbox or patient portal is deliberately vague — it typically shows a total amount due with broad categories like "hospital services" or "lab and pathology." An itemized bill, by contrast, lists every individual charge: every medication administered, every supply used, every test ordered, and every minute of provider time billed.

This matters because billing errors are rampant in American healthcare. The Medical Billing Advocates of America estimates that 30-80% of hospital bills contain errors. A 2023 study published in the Journal of the American Medical Association found that billing errors added an average of $1,300 to hospital stays. These are not small rounding differences — they are charges for services that never happened, duplicate entries for the same test, and incorrect billing codes that inflate the price of a procedure.

To request an itemized bill, call the phone number on your bill and say: "I need a fully itemized bill showing every individual charge with the CPT code and description for each line item." Under federal law, healthcare providers must furnish an itemized statement upon request. If the representative is hesitant, reference Section 2718 of the Affordable Care Act and your right to transparent billing information.

Once you have the itemized bill, review it carefully for these common errors:

• Duplicate charges: The same test, medication, or service appearing twice. This happens frequently when care transfers between departments (admission to a room, room to recovery, etc.)
• Upcoding: A procedure billed at a higher complexity level than what was actually performed. For example, billing a complex wound repair (CPT 13132) when simple sutures (CPT 12001) were used, which can add $500-$2,000 to your bill
• Unbundling: Billing individual components of a procedure separately when they should be billed as a single bundled service. For example, billing a blood draw, the collection tube, the lab processing, and the results interpretation as four separate charges instead of one lab panel
• Charges for cancelled services: Tests that were ordered but never performed, or procedures that were scheduled but cancelled, still appearing on the bill
• Operating room time errors: Being billed for more time in the operating room than the surgery actually required. Operating room fees run $50-$150 per minute, so even 15 extra minutes adds $750-$2,250
• Supply upcharges: Dramatically inflated charges for basic supplies — $50 for a pair of non-sterile gloves, $500 for a standard cervical collar that costs $20 retail

If you identify errors, call the billing department and dispute each incorrect charge specifically. Say: "I am reviewing my itemized bill and I see a charge for [specific item] on [date]. I do not believe this service was provided, and I am requesting its removal." Document everything — the date of your call, the name of the representative, and what was discussed. Follow up in writing via certified mail to create a paper trail.

Step 2: Verify Insurance Was Applied Correctly

If you have health insurance, the next step is to compare your hospital bill against your Explanation of Benefits (EOB) from your insurance company. The EOB shows what the provider billed, what your insurance approved, what they paid, and what you owe. Discrepancies between the EOB and the provider's bill are common and almost always favor the provider.

Check for these specific insurance-related billing issues:

Out-of-network billing when you should be in-network. If your primary hospital or physician is in-network but another provider who treated you (an anesthesiologist, radiologist, pathologist, or assistant surgeon) was out-of-network, you may be getting balance-billed for the difference. Under the No Surprises Act (effective January 2022), this type of surprise billing is prohibited for emergency services and many non-emergency services at in-network facilities. If you see out-of-network charges for providers you did not choose, dispute them immediately.

Coding errors that affect insurance payment. A single incorrect diagnosis code (ICD-10) or procedure code (CPT) can cause your insurance to deny a claim or pay a lower amount. For example, if a diagnostic colonoscopy is coded as a screening colonoscopy, your insurance cost-sharing obligations change dramatically. If a claim was denied for coding reasons, ask the provider's billing department to review and resubmit with the correct codes.

Pre-authorization failures. Some services require prior authorization from your insurer. If your provider failed to obtain authorization, the claim may be denied — but this is typically the provider's responsibility, not yours. Contact your insurance company to understand why the claim was denied, and work with the provider's billing office to secure retroactive authorization.

Failure to apply your deductible correctly. Verify that your insurance correctly tracked your year-to-date deductible and out-of-pocket maximum. Errors here mean you could be paying more than you owe. Cross-reference your EOB amounts with previous EOBs from the same plan year. If you have already met your deductible but the latest claim was processed as though you had not, call your insurer to request a reprocessing.

For ongoing challenges with your health insurance coverage, understanding your plan's appeals process is critical. Insurance denials are not the final word — you have the right to appeal, and a significant percentage of appeals are successful.

Step 3: Check Fair Market Pricing

Once you have a clean, verified itemized bill, the next step is to determine whether the prices themselves are reasonable. Most patients assume that a hospital bill reflects the "going rate" for services, but hospital pricing varies wildly — the same procedure can cost $2,000 at one hospital and $12,000 at another hospital across town.

Use these free tools to check what your care should cost:

Healthcare Bluebook (healthcarebluebook.com): This tool shows the "fair price" for medical procedures in your area. The fair price represents what insurance companies typically pay — which is usually 40-60% of what hospitals charge uninsured patients. Search for your specific procedures by name or CPT code to see the fair, low, and high prices in your zip code.

FAIR Health Consumer (fairhealthconsumer.org): Operated by the nonprofit FAIR Health organization, this tool provides cost estimates for medical and dental procedures based on actual claims data. It shows what providers in your area typically charge and what insurance typically pays, broken down by the 50th and 80th percentiles.

Medicare rates as a benchmark: Medicare publishes the rates it pays for every medical service through the Physician Fee Schedule and the Inpatient Prospective Payment System. While you cannot demand Medicare rates as a private patient, knowing that Medicare pays $3,500 for a procedure your hospital billed at $15,000 gives you powerful leverage. Medicare rates are available at cms.gov and represent the floor of what most hospitals will accept, since accepting Medicare patients at those rates is already profitable for them.

Hospital price transparency data: Since January 2021, the CMS Hospital Price Transparency Rule requires all hospitals to publish their standard charges online in a machine-readable file. This includes gross charges, discounted cash prices, payer-specific negotiated rates, and the minimum and maximum negotiated rates. Search for your hospital's name plus "price transparency" or "standard charges" to find their published data. Seeing that your hospital accepts $4,000 from Blue Cross for the same procedure they billed you $12,000 gives you a concrete number to negotiate toward.

Armed with this pricing data, you now have factual evidence to support your negotiation. You are not just asking for a discount because you cannot afford the bill — you are demonstrating that the charges are inflated compared to established benchmarks.

Step 4: Negotiate Directly With the Billing Department

With your itemized bill reviewed, insurance verified, and fair pricing researched, you are ready to call the billing department. This is the step that saves most patients the most money, and it is simpler than most people expect. Billing department staff negotiate payments every day — your call is not unusual or confrontational.

Here is how to structure the conversation, with exact scripts you can use:

Opening the Negotiation

Call the billing department during weekday mornings (Tuesday through Thursday tend to have shorter hold times) and say: "Hi, my name is [name] and my account number is [number]. I have received my bill and reviewed the itemized charges. I would like to discuss options for reducing my balance." This opening signals that you are informed and prepared, which typically leads to better offers.

Ask for a Cash-Pay or Prompt-Pay Discount

The simplest negotiation strategy: "Do you offer a cash-pay discount or a prompt-pay discount for patients who can pay today?" Most hospitals and medical practices offer cash-pay discounts of 20-40% off the billed amount. Some hospitals offer discounts as high as 50-60% for immediate payment. This is the single easiest way to reduce your bill because it requires no documentation, no proof of income, and no lengthy approval process.

Reference Fair Market Pricing

If the cash-pay discount does not bring your bill to a reasonable level, use the pricing data you gathered: "I have researched the fair market rate for these services using Healthcare Bluebook and FAIR Health, and the typical cost in my area is $[amount]. I also see that Medicare pays $[amount] for this procedure. I would like to negotiate my bill down to a rate that is closer to the fair market value." This approach is particularly effective for large hospital bills where the gap between billed charges and fair market rates can be tens of thousands of dollars.

Make a Lump-Sum Settlement Offer

If you can afford to pay a significant amount upfront but not the full balance, offer a lump sum: "I can pay $[amount] today to settle this account in full. Is that something you can accept?" Start your offer at 30-40% of the balance. The billing department will likely counter at 50-70%. Most negotiations settle somewhere in the 40-60% range for lump-sum payments. Hospitals strongly prefer receiving cash now over chasing payments for months, which makes lump-sum offers highly effective.

Escalate When Necessary

If the first representative cannot authorize a significant reduction, ask to speak with a supervisor or the patient financial services manager. Say: "I appreciate your help, but I need to speak with someone who has the authority to negotiate a settlement on this account." Supervisors typically have broader authority to approve reductions and may offer options the initial representative could not.

Always get any agreed-upon reduction or settlement in writing before making payment. Ask: "Can you send me written confirmation of this agreement showing the reduced amount and that payment of $[amount] will satisfy the account in full?" This protects you from the hospital later claiming you still owe the difference.

Negotiation Strategies Compared

Different situations call for different approaches. Here is how the major negotiation strategies compare in terms of typical savings, difficulty, and best use cases:

Most patients achieve the best results by combining multiple strategies. Start with billing error correction (which removes illegitimate charges), then negotiate the remaining balance using fair pricing data and a cash-pay or lump-sum offer. If you qualify for charity care, apply for that instead — it may eliminate the bill entirely.

Hospital Charity Care and Financial Assistance

One of the most powerful tools for reducing medical bills is hospital financial assistance, commonly called charity care. Under Section 501(r) of the Affordable Care Act, every nonprofit hospital in the United States is legally required to have a written financial assistance policy, make that policy available to patients, and provide free or discounted care to eligible patients. Since approximately 57% of all U.S. hospitals are nonprofit entities, this requirement covers the majority of hospital systems in the country.

Charity care programs vary by hospital, but most follow a similar framework:

• Free care: Patients with household incomes below 200% of the federal poverty level (FPL) — $62,400 for a family of four in 2026 — typically qualify for 100% free care, meaning the entire bill is written off
• Reduced-cost care: Patients with incomes between 200-400% of FPL ($62,400-$124,800 for a family of four) often qualify for discounts of 25-75% depending on the hospital's sliding scale
• Some hospitals extend further: Certain large hospital systems set their charity care threshold at 400% or even 500% of FPL, covering households with incomes up to $156,000 for a family of four

To apply for charity care, follow these steps:

Step 1: Request the hospital's financial assistance application. Every nonprofit hospital is required to provide this upon request. You can usually find it on the hospital's website under "billing," "financial assistance," or "patient services." If you cannot find it online, call the billing department and ask them to mail or email the application to you.

Step 2: Gather your documentation. Most applications require proof of income (recent pay stubs, tax returns, or a letter from your employer), proof of household size (tax return or signed statement), bank statements (typically the most recent 2-3 months), and identification. Some hospitals also ask for a hardship letter explaining your situation.

Step 3: Submit the completed application. You typically have 240 days from the first billing date to apply. While your application is under review, the hospital cannot send your bill to collections or take any extraordinary collection actions (wage garnishment, credit reporting, lawsuits).

Step 4: Follow up. Processing times range from 2-8 weeks. Call the financial assistance office every two weeks to check on your application status. If your application is denied, ask for the specific reason and whether you can appeal or provide additional documentation.

Many eligible patients never apply for charity care because they do not know it exists. A 2023 report from the Kaiser Family Foundation found that nonprofit hospitals collectively provide about $16 billion in charity care annually, yet billions more go unclaimed because patients are unaware of their eligibility. If your income is below 400% of FPL and you have a significant hospital bill, always apply — the potential savings are too large to leave on the table.

No Surprises Act Protections

The No Surprises Act, which took effect on January 1, 2022, provides critical protections against some of the most financially devastating types of medical billing. Understanding these protections can save you thousands of dollars and give you grounds to dispute charges that would have been unavoidable before the law existed.

The key protections include:

Emergency services. For all emergency medical services — including those provided at out-of-network emergency departments and by out-of-network providers at in-network emergency facilities — you cannot be balance-billed for amounts exceeding your in-network cost-sharing. This means if you go to an ER and are treated by an out-of-network physician, that physician cannot send you a separate bill for the difference between their charge and what your insurance paid. Your maximum out-of-pocket is limited to your plan's in-network cost-sharing amount.

Non-emergency services at in-network facilities. If you receive non-emergency care at an in-network hospital or ambulatory surgical center but are treated by an out-of-network provider you did not choose (such as an anesthesiologist, pathologist, radiologist, or assistant surgeon), you are protected from balance billing. The out-of-network provider must accept your plan's in-network rate, and you are only responsible for your in-network cost-sharing amount.

Air ambulance services. Out-of-network air ambulance providers cannot balance-bill you beyond your in-network cost-sharing amount. Given that air ambulance bills frequently exceed $40,000-$100,000, this protection alone can prevent financial devastation.

Good faith estimates for uninsured patients. If you are uninsured or self-pay, healthcare providers must give you a good faith estimate of expected charges before providing non-emergency services. If the final bill exceeds the estimate by $400 or more, you have the right to dispute the bill through a patient-provider dispute resolution process administered by the Department of Health and Human Services.

If you receive a bill that you believe violates the No Surprises Act, you can file a complaint with the Centers for Medicare and Medicaid Services (CMS) at 1-800-985-3059 or through the No Surprises Help Desk at cms.gov. Many states also have additional balance billing protections that go beyond federal law.

Medical Billing Advocates

For patients facing very large bills ($10,000+), complex billing situations, or who simply do not have the time or confidence to negotiate themselves, a medical billing advocate can be a worthwhile investment. These professionals specialize in reviewing medical bills, identifying errors, and negotiating directly with providers and insurance companies on your behalf.

Medical billing advocates typically work on one of two fee structures:

• Contingency fee: The advocate charges 25-35% of the amount they save you. If they reduce a $20,000 bill by $12,000, their fee would be $3,000-$4,200. You only pay if they achieve savings. This is the most common arrangement and eliminates financial risk for the patient.
• Hourly rate: Some advocates charge $75-$200 per hour for their time. This structure is better for smaller bills or quick reviews where the contingency model does not make financial sense.

Good medical billing advocates typically save their clients 25-50% on hospital bills. They are particularly effective at identifying billing errors, since they know medical billing codes intimately and can spot upcoding, unbundling, and other irregularities that patients would miss. They also have experience navigating hospital bureaucracies and insurance appeal processes.

To find a reputable billing advocate, check the Alliance of Claims Assistance Professionals (claims.org) or the Medical Billing Advocates of America (billadvocates.com). Verify that any advocate you hire has relevant credentials (Certified Medical Billing Specialist, Certified Professional Coder) and check for reviews or references from previous clients. Avoid any advocate who asks for payment upfront before reviewing your bill.

Payment Plans and Financing Options

If you have negotiated your bill as far down as possible but still cannot pay the remaining balance in full, several payment options exist. The right choice depends on the amount owed, your cash flow, and the interest rate — because some options that appear helpful are actually financial traps.

Hospital Payment Plans (Recommended)

Most hospitals offer interest-free payment plans for patients who cannot pay in full. These plans typically stretch over 6-24 months with equal monthly payments. Hospital payment plans are almost always the best option because they carry zero interest, have no credit check, and keep your account in good standing (out of collections). To set one up, call the billing department and say: "I would like to set up a monthly payment plan. What are the minimum payment and term options?" If the minimum payment is still too high, negotiate lower — many hospitals will accept payments as low as $25-$50 per month to keep the account active.

Medical Credit Cards (Use With Extreme Caution)

Medical credit cards like CareCredit and Scratchpay offer promotional periods of 0% interest for 6, 12, 18, or 24 months. They are widely accepted at hospitals, dental offices, veterinary clinics, and other healthcare providers. However, these cards come with a dangerous feature called deferred interest. If you do not pay the entire balance before the promotional period ends, you are charged interest retroactively from the date of purchase — typically at rates of 26.99-29.99% APR. On a $5,000 balance with a 12-month promotional period, failing to pay off the final $200 before the deadline triggers approximately $1,400 in retroactive interest charges. Only use a medical credit card if you are certain you can pay the entire balance before the promotional period expires.

Personal Loans (Better Than Medical Credit Cards)

If you need to finance a large medical bill and cannot get an interest-free hospital payment plan, a personal loan is generally a better option than a medical credit card. Personal loans offer fixed interest rates (typically 7-20% depending on your credit score), fixed monthly payments, and no deferred interest traps. A $10,000 personal loan at 12% interest over 36 months costs about $332 per month with total interest of approximately $1,960 — significantly less than the retroactive interest charges on a medical credit card.

Health Savings Account (HSA) or Flexible Spending Account (FSA)

If you have funds in an HSA or FSA, use them to pay medical bills. These accounts use pre-tax dollars, effectively giving you a 22-37% discount (depending on your tax bracket) on any medical expense you pay through them. HSA funds roll over indefinitely, while FSA funds typically must be used within the plan year (with some plans offering a grace period or $610 rollover).

When to Dispute With Your Insurance Company

If your insurance company denied a claim, paid less than expected, or applied charges incorrectly, you have the right to appeal. Insurance appeals are worth pursuing — a 2023 analysis found that approximately 50-60% of internal appeals and 40-50% of external appeals result in at least a partial reversal of the original denial.

The appeals process works in stages:

Internal appeal (Level 1): Submit a written appeal to your insurance company within 180 days of the denial. Include the denial letter, a letter from your physician explaining medical necessity, any supporting medical records, and your argument for why the claim should be covered. Your insurance company must respond within 30 days for pre-service claims or 60 days for post-service claims.

Internal appeal (Level 2): If your first appeal is denied, most plans allow a second internal appeal reviewed by a different person or committee. Include any additional documentation or expert opinions that support your case.

External review: If both internal appeals are denied, you have the right to an external review by an independent third-party organization. This reviewer is not employed by or affiliated with your insurance company. External review decisions are binding on the insurer — if the external reviewer overturns the denial, your insurance must pay the claim. To request an external review, contact your insurance company or your state's department of insurance.

State insurance commissioner complaint: If you believe your insurance company is acting in bad faith or violating state insurance regulations, file a complaint with your state's department of insurance. The commissioner's office can investigate, intervene on your behalf, and impose penalties on insurers that violate state law. This is a particularly effective step when dealing with repeated claim denials or unreasonable delays.

Throughout the appeals process, continue making minimum payments on your bill (or maintain your payment plan) to prevent the account from going to collections. Let the provider's billing department know that you are appealing with your insurance company — many will pause collection activity while an appeal is pending.

Medical Debt and Credit Reports

The relationship between medical debt and credit scores has changed significantly in recent years, with several consumer-friendly reforms that reduce the damage medical bills can cause to your financial life.

In 2023, the three major credit bureaus (Equifax, Experian, TransUnion) implemented major changes to how medical debt is reported:

• Paid medical collections are removed: Any medical debt that has been paid or settled is removed from credit reports entirely. Previously, paid medical collections remained on credit reports for up to seven years.
• Medical debt under $500 is excluded: Medical collections with a balance under $500 are no longer included on credit reports, regardless of payment status. This change alone removed medical debt from an estimated 70% of consumers who had medical collections.
• One-year waiting period: Unpaid medical debt cannot appear on credit reports until at least 365 days after it is sent to collections. This gives patients a full year to resolve billing disputes, negotiate reductions, apply for financial assistance, or arrange payment plans before any credit score impact occurs.

The Consumer Financial Protection Bureau has also proposed rules to further restrict medical debt in credit reporting, potentially removing it from credit reports altogether. While the final rulemaking status continues to evolve, the trend is clearly moving toward reducing the credit impact of medical debt.

Practically, this means:

• If you can resolve your medical bill within 12 months of it going to collections — whether through payment, negotiation, financial assistance, or settlement — it will never appear on your credit report
• If you settle a medical debt for less than the full amount, the settled debt is removed from your credit report once marked as paid
• Small medical debts under $500 will not affect your credit regardless of what you do
• Checking your credit report regularly (free at annualcreditreport.com) allows you to catch and dispute any medical debts that are reported incorrectly

It is also worth noting that the statute of limitations on medical debt — the period during which a creditor can sue you to collect — varies by state. In most states, the statute of limitations ranges from 3-6 years, though some states allow up to 10 years. Making a payment on old debt can restart the statute of limitations in many states, so if you are contacted about very old medical debt, consult a consumer rights attorney before making any payment. For a deeper understanding of how debt affects your financial profile, see our credit score guides.

Frequently Asked Questions About Negotiating Medical Bills

Can you negotiate medical bills after they have been sent to collections?

Yes, you can negotiate medical bills even after they go to collections. Collection agencies typically purchase debt for 4-20 cents on the dollar, so they are often willing to accept 25-50% of the original balance as payment in full. Always get any settlement agreement in writing before making payment. Under 2023 CFPB rules, paid medical debt is removed from credit reports, so settling the debt also eliminates the credit score damage. You can also dispute the debt if there are billing errors or if the original provider did not follow proper billing procedures.

What is the best way to negotiate a hospital bill?

The best way to negotiate a hospital bill is to follow these steps: First, request an itemized bill and check for errors (billing errors appear on 30-80% of hospital bills). Second, compare charges to fair market rates using Healthcare Bluebook or FAIR Health Consumer. Third, call the billing department and ask for a cash-pay discount (typically 20-40% off). Fourth, if you qualify based on income, apply for the hospital's financial assistance or charity care program. Fifth, if the bill is still too high, offer a lump-sum payment of 40-60% of the balance. Most hospitals prefer receiving a reduced payment over sending bills to collections.

How much can you realistically reduce a medical bill?

Patients who actively negotiate their medical bills typically save 30-70% off the original amount. Cash-pay discounts alone usually save 20-40%. Finding and correcting billing errors can reduce bills by hundreds or thousands of dollars. Hospital charity care programs can reduce bills by 50-100% depending on your income relative to the federal poverty level. Medical billing advocates report saving their clients an average of 25-50% on hospital bills. The key factor is persistence — patients who call, follow up, and escalate their requests consistently achieve better results than those who accept the first offer.

Does negotiating medical bills affect your credit score?

Negotiating medical bills does not directly affect your credit score. In fact, it can help protect your credit. Under 2023 CFPB rules, medical debt under $500 has been removed from credit reports, and paid medical collections are no longer reported. If you negotiate and pay your bills before they go to collections (usually 90-180 days after the due date), the debt will never appear on your credit report at all. Setting up a payment plan with the provider also prevents the debt from going to collections, as long as you make your payments on time.

Are hospitals required to offer financial assistance for medical bills?

All nonprofit hospitals are legally required to offer financial assistance programs under Section 501(r) of the Affordable Care Act. Since approximately 57% of U.S. hospitals are nonprofit, this covers the majority of hospital systems. These charity care programs typically provide free or heavily discounted care to patients with household incomes below 200-400% of the federal poverty level ($62,400-$124,800 for a family of four in 2026). For-profit hospitals are not legally required to offer financial assistance but many still have hardship programs. You must apply and provide documentation of income, but hospitals cannot deny emergency treatment while your application is being reviewed.