Charity care is the everyday name for hospital financial assistance, the program every New York hospital must run to cancel or cap bills based on household income. New York law calls it financial assistance, and so does the state’s form, the Uniform Hospital Financial Assistance Application. Under either name it is a legal ceiling on what a hospital may charge you, not a favor, and it binds every hospital in the state, including for-profit ones.

Eligibility runs on household income before taxes, measured against the federal poverty level, not on what you own. There is no asset test: the hospital may not ask about your home, your car or your savings, and may not deny you only because a document such as a bank statement is missing. If your income dropped, apply on your current situation and say what changed. There is no deadline either. You can apply before a bill arrives, after it, or after the account has gone to a collection agency.

The part people get wrong is who qualifies. The first mistake is trusting the billing office’s version. If someone tells you the program ends at 300% of the poverty level, that you must be uninsured, or that they need bank statements, they are describing the law before its amendment on October 20, 2024. The second is assuming insurance rules you out. If your out-of-pocket medical costs over the last 12 months exceed 10% of gross income, the law treats you as underinsured, and the same income tiers apply to your share of the bill.

You meet it before you meet the bill. Hospitals with 24-hour emergency departments must post notices at intake and registration and state on bills that financial aid may be available and how to ask. You are also entitled to a plain-language summary at admission, registration or discharge, and a copy with any bill. Online, look under billing or “paying for care” for three documents: the full policy, the application and the summary. The state Department of Health also publishes the information hospital by hospital. A bill that never mentions financial assistance is itself worth raising.

In New York: charity care is a statute with numbers, Public Health Law 2807-k as amended effective October 20, 2024. For emergency and medically necessary care, an uninsured patient at or below 200% of the federal poverty level owes nothing out of pocket; from 201% to 300% the charge may not exceed 10% of the Medicaid rate; from 301% to 400%, 20% of the Medicaid rate. Every hospital licensed by the Department of Health must accept the uniform application, whether or not it takes part in the state’s Indigent Care Pool, and if a hospital hands you its own form you can still use the state’s, which exists in English and 16 other languages. Immigration status may not be considered, applying is not a public benefit for public charge purposes, and hospitals may not report applicants to immigration authorities. A completed application gets a written decision within 30 days, with the appeal procedure. While it is pending the account may not go to a collection agency, no account may go there within 180 days of the first bill, and a patient with income under 400% may not be sued. For whatever is left, the hospital must offer a payment plan capped at 5% of gross monthly income, with interest of no more than 2% a year. Two limits: emergency care is covered for any New York State resident, but non-emergency care only for residents of the hospital’s primary service area; and a physician group billing under its own name is not bound.

What to do:

  • Ask for it by name: the New York State Uniform Hospital Financial Assistance Application and the hospital’s written policy, both in your language.
  • Ask in writing for the account to be held while the application is pending.
  • Send proof of income, not assets: pay stubs, a tax return, benefit letters, an employer letter, or a written attestation if you are paid in cash.
  • If the hospital’s policy is weaker than the law, the law governs. Appeal in writing, then call the Attorney General’s Health Care Bureau Helpline, 800-428-9071.

Also called: financial assistance, hospital financial aid. Full guide: Hospital financial assistance in New York. Reference: Charity care on Wikipedia — general definition, not New York specifics.

More in Glossary of health coverage and billing terms

  • Network (in-network and out-of-network) — The set of doctors and hospitals your plan has contracted with. Outside it, you pay much more.
  • Formulary — A formulary is a plan's list of covered drugs, sorted into tiers that set your cost. What on-formulary means, how exceptions work, and New York's NYRx list.
  • Prior authorization — Prior authorization is a plan's approval before it pays for care. Who asks for it, what a denial says, where the deadlines are, and New York's appeal route.
  • EMTALA — The federal law requiring emergency rooms to screen and stabilize anyone, regardless of insurance or status.
  • MAGI (modified adjusted gross income) — MAGI, modified adjusted gross income, decides Medicaid, Essential Plan and marketplace eligibility and adjusts Medicare premiums. What counts, which year.
  • Underinsured — Having coverage and still being unable to afford care, which in New York is not just a description but a legal category with a threshold.
  • How to Find Any New York Hospital's Financial Assistance Policy — The state health department's directory leads to any New York hospital's financial assistance policy. If a policy is weaker than the law, the law governs.

This page explains how the system works. It is not medical advice. More.