Hospital financial assistance
Know your rights
If your income is below a certain level and you are not fully insured, you may be entitled to financial assistance when you get health care services from a hospital. New York state law requires hospitals to pay for care for people who qualify.
We have developed this guidance to help you understand what your rights are and how to get financial aid from a hospital if you qualify. Note that:
- This law applies only to hospitals. It does not apply to other kinds of health care providers.
- All hospitals in New York state must have financial aid programs. Their programs must include policies for determining financial-assistance eligibility.
New York’s Hospital Financial Aid Law
The Hospital Financial Aid Law (HFAL) is a New York state law that requires hospitals to offer financial assistance to eligible patients who cannot afford their hospital bills. The law is New York Public Health Law section 2807-k(9-a).
Hospitals are required to provide a written summary of their financial aid policies and procedures when you are admitted, registered, or discharged. Hospitals must also include a copy with any bills or financial statements they send you.
Who qualifies for hospital financial aid
You might be eligible for hospital financial aid if you meet the requirements for household income and health insurance status.
Household income
The federal government defines the federal poverty levels (FPLs) for annual income, depending on the size of a household. These FPLs are used to determine eligibility for benefits including whether your income meets the qualifications for hospital financial aid. In most cases, hospitals must offer financial aid to you if your household income is no more than four times or 400% of the federal poverty level (FPL). For example, if you have a family of four with an annual income below $132,000, you might qualify for a discount on health care services.
The hospital calculates the amount of your discount on a sliding scale, depending on your household income. The following numbers are for illustration only. To see current FPLs, visit Federal Poverty Guidelines.
Federal poverty levels (FPLs; 2026)
| Number of people in household | 200% FPL | 300% FPL | 400% FPL |
| One | $31,920 | $47,880 | $63840 |
| Two | $43,280 | $64,920 | $86,560 |
| Three | $54,640 | $81,960 | $109,280 |
| Four | $66,000 | $99,000 | $132,000 |
| Five | $77,360 | $116,040 | $154,720 |
| Six | $88,720 | $133,880 | $177,440 |
| Seven | $100,080 | $150,120 | $200,160 |
Health insurance status
If your household income meets the FPL requirement, you may qualify for hospital financial aid if any of the following is true:
You do not have any health insurance.
- You are underinsured which means you have health insurance, but your out-of-pocket medical costs for the past year are more than 10 percent of your pre-tax household income.
- You have used up your health insurance benefits and can show that you cannot pay for your remaining care.
If you have difficulty paying your bills, you should apply for hospital financial aid even if you do not meet all the requirements. Your hospital may be able to offer you discounts or some other type of financial assistance.
Hospital financial aid covers certain types of medical care
Financial aid typically covers all of the following:
For emergency care: Hospitals must provide financial aid to all eligible New Yorkers who meet the household income and insurance status requirements.
- For non-emergency, medically necessary care: A hospital must provide financial aid only to eligible patients who live in the hospital’s primary care area. Each hospital defines this area in a written summary of its financial aid policies and procedures. These services include medically necessary hospital services, outpatient services provided by the hospital, and inpatient stays.
- For copays and deductibles: You must show your inability to pay these amounts. The hospital can then decide whether it wants to pay these for you.
A hospital cannot do either of the following:
limit financial aid based on your medical condition
- deny you admission or treatment because you have an unpaid medical bill
Applying for financial aid
All New York state hospitals must use the same standard application created by the New York State Department of Health (DOH). You can get the application in any of the following ways:
Download the application from the DOH website in English or 16 other languages.
- Request an application from your hospital’s financial assistance office or billing department.
- Download the application from the hospital’s website.
Frequently asked questions (FAQs) about hospital financial aid
No. You can apply for financial assistance at any time, starting from the day you received services throughout the billing and collections process.
A hospital is permitted to ask for documents and financial information to prove your income and verify your eligibility. The hospital can ask for any of the following:
- proof of household income, such as pay stubs, tax returns, or public benefit statements, or a signed statement of no household income if you have no income
- proof of household size
- proof of identity
- information on medical bills or insurance coverage
A hospital cannot ask for information about assets you own, such as a house or a car. In addition, the hospital cannot deny you financial aid simply because you cannot provide certain kinds of documents, such as bank statements or tax returns.
You are underinsured if your paid medical expenses for the past year are more than 10 percent of your pre-tax household income. These are medical expenses that you have already actually paid for. They include out-of-pocket costs for emergency or medically necessary care, such as deductibles, copays, coinsurance, and deposits, but do not include the cost of health insurance premiums (what you pay for your health insurance each month). Hospitals can ask you to provide proof of paid bills to show to that you are underinsured.
If you qualify for financial assistance, a hospital must offer you a discount based on your income. To calculate your discount, the hospital will consider the following:
- your household’s annual income, compared with the FPL
- your insurance status, that is, whether you are insured or uninsured.
| Household income level | What the hospital may charge you |
| Less than 200 percent FPL | Waive all charges |
| 200 to 300 percent FPL | If you are uninsured: The hospital may charge you up to 10 percent of the amount that Medicaid would have paid for the service. The hospital applies a sliding scale to that amount to determine your charge, so you may pay less than that amount. If you are underinsured: The hospital may charge you up to 10 percent of the amount that you would have been required to pay through your insurance plan. |
| 301 to 400 percent FPL | If you are uninsured: The hospital may charge you up to 20 percent of the amount that Medicaid would have paid for the service. The hospital applies a sliding scale to that amount to determine your charge, so you may pay less than that amount. If you are underinsured: The hospital may charge you up to 20 percent of the amount you would have been required to pay through your insurance plan. |
A hospital may provide or offer other discounts if your income is higher than 400% FPL.
If you qualify for financial aid, a hospital must offer you a monthly installment payment plan. The amount you pay each month cannot be greater than five percent of your pre-tax monthly income. These plans cannot charge more than two percent annual interest.
Any amount you owe for medical services under a monthly installment plan is treated as medical debt subject to the protections of the Fair Medical Debt Reporting Act.
You can do any of the following:
- Ask the hospital’s financial assistance office. The hospital must list the office’s contact information in its standard financial aid application.
- Speak with a patient advocate or social worker.
- Contact a community-based organization that helps with medical bills.
- Visit the New York State Department of Health website for more information.
A hospital must make a decision on your financial aid within 30 days of receiving your completed application. The hospital must give you a written explanation of its decision.
If you are denied financial aid, you have a right to appeal. In addition, you may be able to appeal the amount of your financial aid – that is, you may be able to ask for a larger amount than you were awarded. The hospital must include information about how to appeal in its written decision.
No. A hospital cannot send your bill to a debt collector while it is reviewing your application. The hospital must also give you time to appeal a denial or the amount of your financial aid.
Even if you do not apply for financial aid, a hospital cannot send your bill to a collector for at least six months after it sends you your first bill.
File a complaint about not getting access to hospital financial aid
Notify the Office of the New York Attorney General if you believe a hospital is doing any of the following:
- fails to offer you hospital financial aid
- improperly disqualifies you for financial aid
- improperly sends your hospital bill to a debt collector
- unlawfully sues you for medical debt