Plain-English guide
Hospital charity care, explained and applied
IRS Section 501(r) requires a tax-exempt hospital facility to maintain and publicize a written Financial Assistance Policy. The policy itself controls the criteria and application method. Here is how to inspect and use it.
How to apply, step by step
- 1
Find the hospital's Financial Assistance Policy (FAP)
A tax-exempt hospital facility subject to Section 501(r) must establish a written FAP and widely publicize it. Ask the billing office for the current policy, plain-language summary, and application, and compare them with the versions on the hospital's official website.
- 2
Check the eligibility criteria
The FAP must describe its eligibility criteria and whether assistance includes free or discounted care. Read that hospital's current policy rather than relying on a generic income threshold.
- 3
Gather only the documents the policy requests
Use the hospital's current FAP and application as the checklist. Ask the hospital's financial-assistance contact to explain any unclear item, and keep copies of what you submit and when you submit it.
- 4
Apply within the published window
For the federal Section 501(r) reasonable-efforts rules, the application period ends no earlier than the 240th day after the first post-discharge billing statement. A hospital may accept applications later, but do not assume it will; verify the current FAP and contact the hospital promptly.
- 5
Know the federal protections
For emergency or other medically necessary care, a person found FAP-eligible may not be charged more than the amounts generally billed to people with insurance. A hospital must also make reasonable efforts to determine FAP eligibility before engaging in extraordinary collection actions.
No income screen, provider name, bill amount, phone, or email.
Common questions
Do I have to be uninsured to get charity care?
Not necessarily. The IRS says the amounts-generally-billed limit applies to both insured and uninsured people who are FAP-eligible, but each hospital's written FAP defines its eligibility criteria. Check the current policy rather than inferring eligibility from insurance status.
The bill already went to collections — is it too late?
Do not assume it is too late. During the required application period, a hospital must accept and process a FAP application to satisfy the Section 501(r) reasonable-efforts rules. If a timely complete application shows you are eligible, the regulations require specified corrective steps, which can include reversing extraordinary collection actions and refunding certain excess payments. Ask the hospital for its current FAP immediately.
What is 'presumptive eligibility'?
A hospital may use information other than a new application, or a prior FAP determination, to presume that someone is eligible. That does not guarantee automatic eligibility. The hospital's FAP must describe whether and how it uses presumptive determinations, so verify the current policy.
Sources: IRS,Financial assistance policies,Section 501(r)(5) limits on charges, andSection 501(r)(6) billing and collections. IRS pages last reviewed July 2–3, 2026; this guide last reviewed August 9, 2026. Eligibility criteria, forms, and any later-application policy are set by each hospital. Verify with the official IRS sources and the hospital's current FAP before relying on this information. General information, not financial or legal advice.