New York’s hospital financial assistance law works off one ratio: your household income divided by the federal poverty level for your household size. Everything else follows from where that number lands.
Nothing here is sent anywhere — the math runs in your browser and we store nothing. This is an estimate against published thresholds, not a hospital's decision.
The formula, in the open
We don’t think you should trust a calculator that won’t show its arithmetic. Here is all of it:
100% FPL = $15,960 + (household size − 1) × $5,680 (2026, 48 contiguous states + D.C.)
your percentage = annual household income ÷ 100% FPL × 100
And the thresholds that percentage runs into:
| Percentage of FPL | What New York law says |
|---|---|
| ≤ 200% | A hospital may not charge an uninsured patient out-of-pocket costs |
| 201%–300% | Charges capped at 10% of the Medicaid rate |
| 301%–400% | Charges capped at 20% of the Medicaid rate; the hospital may not sue you |
| Above 400% | No statewide floor, but many hospitals discount here under their own policies |
| Any income, insured | Assistance applies when 12 months of medical bills exceed 10% of gross annual income |
What this estimate is not
It is not a decision. The hospital decides, using its own written policy, and many New York hospitals are more generous than the statutory minimum — a number of them extend help past 400%. An estimate that says “above the threshold” is a reason to read that hospital’s policy, not a reason to pay the bill.
It also doesn’t account for household composition edge cases, income that changed mid-year, or assets — none of which we ask you for, because we don’t want your data.
What to do with the answer
If you’re at or below 200%: call the billing department and ask for the financial assistance application by name. Ask them to pause collection activity while it’s pending. Full walkthrough.
If you’re between 201% and 400%: the same call, and add one sentence: ask what the Medicaid rate for your service was, because 10% of that (up to 300%) or 20% of that (301% to 400%) is your ceiling.
If you’re above 400%: apply anyway, and ask for the hospital’s own policy in writing. Also ask for an itemized bill: at this income level, billing errors cost you more than eligibility rules do.
If you’re uninsured and this keeps happening: the underlying fix is coverage. Start with the Essential Plan if your income is under 200% FPL, or NYC Care if insurance isn’t available to you.
Sources
- NY Health Access — NYS Hospital Financial Assistance Law (checked 2026-08-12)
- HHS 2026 Poverty Guidelines (Federal Register, January 15, 2026) (checked 2026-08-12)
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This page explains how the system works. It is not medical advice. More.