Can the hospital lower your bill?

What it compares

The checker turns your income into a yearly amount (a monthly amount is multiplied by twelve) and compares it with the federal poverty guideline for your household size. The result is your income as a share of that guideline, rounded down to a whole percent. Hospitals and states often set their income limits the same way, as a share of the guideline.

The data

We use the 2026 HHS poverty guidelines, published in the Federal Register on January 15, 2026. Alaska and Hawaii have their own, higher amounts. The checker uses the ones for the state where you got care. Here is the table it reads:

The federal rules it checks

Every nonprofit hospital must have a written financial assistance policy, and a hospital that breaks the federal rules can lose its tax exemption Source 11. The policy must cover emergency and other medically necessary care. Federal law sets no income limit: each hospital, or its state, decides who qualifies Source 22. That is why, without a state rule, the checker says "You may qualify" instead of yes or no. For-profit and government hospitals are not covered by these federal rules, though state law may still apply Source 11. The deadline it shows comes from the same rules: a nonprofit hospital must accept applications for at least 240 days (IRS, published July 2, 2026) after the first bill sent after you leave.

The states it covers

We have written down the rules of two states:

• California. Hospitals must offer charity care or a discount to uninsured patients and to patients with high medical costs. The family income limit, as a share of the guidelines, is 400% (California HCAI, Hospital Fair Billing Program, Effective January 1, 2022) State law; check the effective date and the hospital's own policy. Last checked November 2, 2026.
• Washington. Full charity care and discounts reach different incomes depending on the size of the hospital. At larger hospitals, the income limit for full charity care, as a share of the guidelines, is 300% (Revised Code of Washington 70.170.060, Care from July 1, 2022) State law; check the effective date and the hospital's own policy. Last checked November 2, 2026.

The checker applies a state's rule only after a reviewer has checked it against the law and we rate the source as high confidence. Until then, it treats that state like every other state and tells you that we have not verified its rules yet. Nobody has reviewed these two rules yet, so today every state gets the federal answer.

Why not other states yet

Several other states set their own income levels, among them Illinois, Colorado, Maryland, New Jersey, New York, Oregon, Vermont and Maine Source 33. We have only seen those levels in a secondary summary. We add a state after we have read its law and a reviewer has checked it.

Territories and care outside the US

HHS does not set poverty guidelines for Puerto Rico or the other territories, so each hospital and program there sets its own rules. The checker says so and points you to the billing office. For care outside the United States, it points you to the hospital or your insurer.

What it cannot know

• The hospital's own income limits and discounts, which can reach higher incomes than a state requires.
• How the hospital counts your household and your income, and which year's guidelines it uses.
• Whether your care counts as emergency or medically necessary under its policy.
• Whether a doctor, lab or ambulance that billed you separately is covered by the hospital's policy. The policy must list which providers it covers Source 22.
• Whether the hospital would approve you without an application. A nonprofit hospital may screen patients automatically and decide they qualify, using information such as enrollment in a public benefits program. This is called presumptive eligibility Source 77.

The hospital decides

This is an estimate, not a decision. Only the hospital can decide, under its own policy and the law. If you think you might qualify, apply, even if the checker says your income is above a limit.

Your answers stay with you

The arithmetic runs in your browser. When you finish, we record only that someone completed the checker, never your answers or your result.