Who Qualifies for Financial Assistance for Medical Bills in the US

If you're struggling to pay medical bills, you're not alone. Many Americans face this challenge every year.

People who qualify for financial assistance for medical bills typically have a household income at or below 200% of the federal poverty level. This means if you're a single person, your income must be $25,760 or less per year.

Those with disabilities may also qualify, regardless of income level. This includes individuals with conditions like cancer, kidney disease, and HIV/AIDS.

Low-income families with children may also be eligible for assistance, including families with Medicaid coverage.

Being medically indigent means you're struggling to pay your medical bills due to financial constraints. You're not eligible for free care, but you may qualify for a reduced payment plan. To be considered medically indigent, your medical bills must exceed 5% of your yearly household income, and your income must be between 200% and 500% of the federal poverty guidelines.

The income thresholds for medically indigent classification vary based on household size. For example, with a household size of 4, your yearly income must be less than or equal to $156,000 to qualify for reduced payments. If your bills exceed 5% of your income, you may be eligible for a payment plan that's the lesser of your account balance or 10% of your gross charges.

Here's a breakdown of the income thresholds for medically indigent classification:

If you're struggling to pay your medical bills, don't hesitate to reach out to your healthcare provider to discuss possible payment plans or financial assistance options.

Medical Assistance is available to help with medical bills. You can apply for Medical Assistance programs at your local health department, local department of social services, Dr.'s office, and hospital Social Work Departments.

Maryland Children's Health Insurance Program (MCHP) provides full health benefits for children under 19 and pregnant women with incomes at or below 200% of the federal poverty level. The program covers children who are not eligible for Medicaid and those of employed parents whose employer doesn't offer family health insurance.

To apply for MCHP, you can complete an application online at https://www.marylandhealthconnection.gov/ or by calling the Maryland Health Benefits Exchange Consolidated Service Center at (855) 642-8572 or TTY (855) 642-8573. You can also apply at your local health department or local department of social services.

Medicare Buy-In Program, also known as QMB and SLMB, helps low-income Medicare beneficiaries pay for out-of-pocket costs, including deductibles and copayments. You can contact 1-800-332-6347 or TTY 1-800-735-2258 for more information.

Other government programs, such as Medicaid, Children's Health Insurance Program (CHIP), and Medicare, can also help pay for medical care. These programs may cover vision and dental care, depending on your income, age, employment status, and qualifying health issues.

Some programs offer free or low-cost care for specific health conditions, including breast and cervical cancer screenings through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and HIV/AIDS treatments through the Ryan White HIV/AIDS Program.

You can also get help paying medical bills through debt management plans, which involve a payment schedule developed by a credit counselor. This can help you pay off medical debt with lower interest rates and waived fees.

If you're struggling to pay your medical bills, there are several programs and funding options available to help. Baylor Scott & White Health offers a Financial Assistance Program to patients who can't afford their medical bills, including those without health insurance and those with insurance but can't pay their share.

Government programs can also help pay for medical care, including Medicaid, Children's Health Insurance Program (CHIP), Medicare, and The Affordable Care Act (ACA) / Health Insurance Marketplace. These programs can also provide assistance with vision and dental care.

To get help paying for prescription drugs, you can contact the pharmaceutical companies that make your prescription drugs or devices, or learn about generic drugs that can lower your costs. You can also contact your state social services agency for referrals to local health centers and organizations that may be able to help.

Here are some government programs that can help pay for medical care:

In some cases, you may be able to get help paying your medical bills with a debt management plan, which involves a payment schedule developed by a credit counselor. This can help you lower your interest rates and certain fees to make it easier to pay off your medical debt.

If you're struggling to pay for prescription drugs, there are several options to explore. Contact the pharmaceutical companies that make your prescription drugs or devices to ask about low-cost options, samples, or discounts.

You can also learn about generic drugs, which can be a cost-effective alternative to brand-name drugs. Generic drugs have the same active ingredients and are just as effective, but at a lower price.

State social services agencies can provide direct assistance to people with limited access to healthcare. They can offer referrals to local health centers and organizations that may be able to help.

If you're eligible for Medicare, you can get help paying for your prescriptions through Medicare Part D. This program offers prescription coverage and can be a significant cost-saver.

To get prescription coverage if you choose Medicare Part C, be sure to select a Medicare Advantage Plan that offers prescription drug coverage. This will ensure you have access to the medications you need.

Here are some steps you can take to get help paying for prescription drugs:

Baylor Scott & White Health offers a Financial Assistance Program to patients who can't pay their medical bills, including those without health insurance or those who have insurance but can't afford their portion of the bill.

Patients who are eligible for the Financial Assistance Program may receive reduced or waived medical bills, making it easier to get the care they need.

Government programs like Medicaid, the Children's Health Insurance Program (CHIP), and Medicare can also help pay for medical care, including vision and dental care.

To be eligible for these programs, patients must meet certain requirements based on their income, age, employment status, and qualifying health issues.

The Affordable Care Act (ACA) / Health Insurance Marketplace is another option for patients who need help paying for medical care, as it provides access to health insurance plans and financial assistance.

Here are some government programs that can help pay for medical care:

In some cases, patients may be able to get help paying their medical bills through a debt management plan, which involves working with a credit counselor to develop a payment schedule.

At the federal level, compliance with financial assistance rules is not systematically monitored and enforced. Many state attorneys general, however, actively monitor and enforce compliance with state laws requiring financial assistance for qualifying patients.

Some states, like Washington, have taken action against hospitals that fail to provide free or discounted care to low-income patients.

In North Carolina, there is no public official or agency responsible for enforcing the provision of financial assistance by nonprofit hospitals, according to a 2021 report by the North Carolina State Health Plan and the Johns Hopkins Bloomberg School of Public Health.

This lack of oversight allows hospitals to collect state tax exemptions without providing sufficient financial assistance.