Nonprofit hospital financial assistance rules
IRS Section 501(r) Hospital Financial Assistance Rules
Last updated: June 2026
Many nonprofit hospitals must have a written financial assistance policy for emergency and medically necessary care. The rules and income limits vary by hospital, so patients should ask for the policy and apply before paying a bill they cannot afford.
What hospital financial assistance rules protect
- A written financial assistance policy at hospitals that must meet federal nonprofit hospital requirements.
- A plain-language summary of the policy and how to apply.
- Eligibility rules that explain whether help includes free care, discounted care, or both.
- Policies that apply at least to emergency and other medically necessary care covered by the hospital policy.
What hospital financial assistance does not guarantee
- It does not mean every hospital will forgive every ER bill.
- It does not guarantee the same discount at every hospital.
- It may not cover every separate bill, such as physician groups, ambulance companies, or outside labs.
- It does not prevent all collection activity if you miss application deadlines or do not respond.
What to ask for
- Ask for the hospital's financial assistance policy and plain-language summary.
- Ask for the financial assistance application before making a large payment.
- Ask whether the policy covers the ER facility bill and any related physician or lab bills.
- Ask whether the hospital can pause collections while your application is reviewed.
Steps to take
- Find the hospital's financial assistance page or call the billing office.
- Request an itemized bill and financial assistance application.
- Submit proof of income or household information the hospital requests.
- Keep confirmation that your application was submitted and follow up before any stated deadline.