What is IRS 501(r) charity care?

IRS 501(r) charity care is the federal rule that requires every U.S. non-profit hospital to publish and follow a Financial Assistance Policy offering free or discounted care to eligible low- and middle-income patients. Up to 49% of medical bills contain at least one error (CFPB, 2023), and even before disputing errors, 501(r) charity care can wipe out or reduce balances at qualifying hospitals. The Affordable Care Act § 9007 added these requirements in 2010.

Who qualifies for hospital charity care?

Who qualifies for hospital charity care depends on the individual hospital, but typical 501(r) policies offer 100% charity care up to 200% of the Federal Poverty Level and a sliding discount up to 400% FPL. Up to 49% of medical bills contain at least one error (CFPB, 2023), so apply for charity care AND audit the underlying bill in parallel. Some hospital systems extend partial assistance up to 500% FPL.

Can I apply for charity care after I already received the bill?

Yes, you can apply for charity care after you receive the bill — federal law gives you at least 240 days from the first post-discharge billing statement to submit a Financial Assistance application. About 73.7% of patients who actually dispute a medical bill receive a correction (JAMA Health Forum, 2024). While the application is pending, the hospital cannot send your account to extraordinary collection actions like lawsuits, garnishment, or credit reporting.

Free charity care matcher

You may not owe that hospital bill at all.

Most U.S. non-profit hospitals are required by IRS Section 501(r) to provide free or steeply discounted care to eligible patients. Tell us your hospital, household size, and income — we'll tell you if you likely qualify and exactly how to apply.

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Hospital or health system *

Use the full system name. Most non-profit hospitals (~60% of US hospitals) are subject to 501(r).

Household size *

Annual household income (USD) *

State (optional, for FPL math)

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How it works

Three things determine eligibility.

Is the hospital a non-profit? Most large U.S. hospital systems are. For-profit hospitals (HCA, Tenet, etc.) are not subject to 501(r), but many still offer financial assistance — just under different rules.
What does their FAP say? Each non-profit publishes its Financial Assistance Policy. We'll find it for you. Typical thresholds: 100% relief up to 200% FPL, sliding-scale discounts to 400% FPL, with some systems extending to 500% FPL.
Where does your household income fall? We use the 2026 HHS FPL guidelines to compute your % of FPL. The eligibility tier comes from there.

If you qualify, the hospital is generally required to limit your charges to "amounts generally billed" (AGB) — the rate insurers pay, not the inflated chargemaster rate.

Already paid the bill? You may still qualify for a refund.

Federal law gives you at least 240 days from the first billing statement to submit a Financial Assistance application. Many hospitals will refund payments made by patients who later qualify.

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