Hospital bill help in Washington including free care, discounts, and ways to erase debt.
Washington law gives residents unusually broad rights to free or discounted hospital care. Every hospital in the state must screen patients for financial assistance as well as “charity care” programs, post clear notices, and even reduce or erase bills for households that meet income limits, even if you are insured. Learn more below on the various programs in the state of Washington that help people get the care they need from a hospital or pay off existing bills.
Charity care laws for hospitals and patients in Washington
Washington’s charity care law requires hospitals to provide free or discounted medically necessary hospital care for low- and moderate-income households . The Department of Health summarizes the current statewide standard, and while income levels can change from time to time, in general hospitals must offer free care for patients at or below 200% of the Federal Poverty Level. This means free medical treatments at a hospital, whether it is emergency or preventative / scheduled services. When it comes to receiving heavily discount care , if you are more “moderate” income, the state of Washington requires patients get significant discounts extend up to 400% of FPL depending on the hospital’s tier. The Department of Health page lists the income ranges of these as well as other programs as well as details on the two hospital tiers created by a 2022 law change. You can review the current thresholds and the state’s explanation here . Also note major Washington hospital systems all operate formal charity care programs that meet or exceed state requirements.
Applying for hospital financial assistance programs in WA
Every hospital in the state of Washington must accept applications at any time, even after a unpaid bill is sent to collections. If you have a hospital bill, start by doing the following. It is always best to be methodical when it comes to asking for, and receiving help. As there are state mandated programs that help patients in Washington pay their past due bills for care. This can of course be combined with other Washington assistance programs that pay additional bills. Ask the hospital’s billing office for its “charity care/financial assistance” application; Washington law requires hospitals to make it available and to post how to apply. Second, tell them in writing that you want your account paused for charity care review. Make sure you request a written determination and keep proof of submission. Third, gather income documentation for everyone in your household who lives with you (pay stubs, W-2, last year’s tax return, approvals/denials for Apple Health or unemployment). As noted, some form of help needs to be provided via state law for residents whose income is up to 400% of FPL. If you are denied or offered only a partial reduction, you can appeal through the hospital or file a complaint with the Washington Department of Health. those details are on the same DOH page listed above. The DOH site also explains what documents count as proof of income and how appeals work. Also file a charity care complaint with the Department of Health and consider contacting the Attorney General’s office consumer resource page on charity care .
Help with existing hospital bills
If you owe past due debt owed to the hospital, or any part of your account, has already gone to collections or turned into a court case, Washington has extra protections around medical debt . State law bars providers from selling or assigning medical debt to a collection agency until at least 120 days after the first bill is sent, and it caps pre-judgment interest on medical debt. Find other ways to get help will bills due from medical care . Be aware of "surprise" or balance billing too . This applies to people that have medical insurance. If your bill came from a visit that should not have been “balance billed,” Washington also enforces protections against surprise billing alongside the federal No Surprises Act. You cannot be charged out-of-network rates for emergency care and certain other services. The Office of the Insurance Commissioner explains what is covered and how to dispute a bill at https://www.insurance.wa.gov/about-us/current-initiatives/protections-surprise-medical-billing . There is even help with hospital bills for state of WA residents that recently lost their insurance policy . People who recently lost coverage or had low income in the months before a hospital visit should check Washington Apple Health (Medicaid) for “retroactive coverage.” If you qualify now, Medicaid can often backdate coverage up to three months before your application, which can wipe out hospital balances from that period. The Washington Health Care Authority helps people ally, and learn more about, the three-month retroactive Apple Health certification window with more details here.
Bottom line
Washington’s laws give patients clear rights to free or discounted hospital care. Most households earning up to 300% 400% of the Federal Poverty Level should not be paying full hospital charges. If you receive a bill, file a charity care application with the hospital that treated you, ask for Apple Health retroactive coverage if you might qualify, and use the state’s surprise billing protections to correct out-of-network pricing. If you were billed when you should have qualified for charity care, you may be entitled to a refund or debt forgiveness. Keep all communication in writing and use the Department of Health and Attorney General resources above for help. Also feel free to use the Department of Health and Attorney General links above for appeal and complaint routes.