Duke Health income limits
| Household size | Free care: yearly income up to 200% | Discounts: yearly income up to 300% |
|---|---|---|
| 1 person | $31,920 | $47,880 |
| 2 people | $43,280 | $64,920 |
| 3 people | $54,640 | $81,960 |
| 4 people | $66,000 | $99,000 |
| 5 people | $77,360 | $116,040 |
| 6 people | $88,720 | $133,080 |
- Free care
- Up to 200% of the federal poverty guidelines: about $66,000 a year for a family of four in 2026.The policy says: “Discount of 100% for individuals with incomes up to 200% FPL.” (page 6)
- Discounts
- Up to 300% of the guidelines: about $99,000 a year for a family of four.The policy says: “the patient must have annual family income less than or equal to 300% of the available current year Federal Poverty Guidelines.” (page 4)
- Sliding scale
- Above 200% to 225%: 90% off; above 225% to 250%: 80% off; above 250% to 275%: 70% off; above 275% to 300%: 65% off. People above 300% may still apply and are looked at under the medically indigent rule.
- With insurance
- The same income limits apply with or without insurance: free up to 200% of the guidelines, sliding discounts to 300%. Non-emergency out-of-network care is excluded for out-of-state patients, and insurance payments received after approval reduce the discount. (Policy, pages 1, 4, 5 and 9.)
- Large bills
- Medically indigent: if the total patient balance is more than 15% of annual household income, the part above 15% of projected household income may be adjusted. This is looked at for completed applications that do not qualify for the sliding scale, including incomes above 300%.
How to apply for Duke Health financial assistance
- Without a full application
- Some patients may be approved without a full application.
- Time to apply
- The policy states no deadline in days. Apply as soon as you can.
- How to apply
- Apply through MyDukeHealth, ask customer service for a form, or send a paper form. Out-of-state applicants must include proof of household income, such as pay stubs, tax returns, W2 or a letter from an employer.
- Differences by state
- North Carolina residents are screened automatically and may be approved with no application if they are homeless, on Medicaid, or on another means-tested program such as SNAP or WIC. Out-of-state patients must apply with income proof, are approved for 6 months, and their non-emergency services with out-of-network insurance are excluded.
- Also good to know
- A payment made before approval is not refundable under this policy. Transplant services and international patients are excluded.
Common questions about Duke Health financial assistance
What is the income limit for Duke Health financial assistance?
Duke Health’s policy lists free care up to 200% of the federal poverty guidelines and discounts up to 300%. With the 2026 guidelines for the 48 states and Washington, DC, that is for free care, a yearly income up to about $31,920 for one person and $66,000 for a family of four; for discounts, a yearly income up to about $47,880 for one person and $99,000 for a family of four. The policy has differences by state or hospital, so check it for your hospital. Duke Health decides from its own application; only the hospital can confirm what you may get.
How do I apply for Duke Health financial assistance?
Apply through MyDukeHealth, ask customer service for a form, or send a paper form. Out-of-state applicants must include proof of household income, such as pay stubs, tax returns, W2 or a letter from an employer. The policy states no deadline in days. Apply as soon as you can.
Source
DUHS Financial Assistance Policy, Revision 11, effective 01/01/2026. Read with AI reading tools on November 6, 2026, and checked by a second one against the same document. There is also a plain language summary.
We are not part of Duke Health. Policies change, and the hospital decides from its own form. If what you read here differs from the current policy, the policy counts.
Ask in writing
The free financial assistance letter asks the hospital for its policy, the application and the plain language summary. Already paid? How applying after you have already paid works. Compare other systems on the hospital list.
Have insurance? See what 38 policies say about patients with insurance.
In North Carolina? Find your hospital by name or town (112 North Carolina hospitals).
Other health systems nearby
Check the bill itself
Financial assistance may lower what you owe, but it does not look at the charges. Open your bill in MedBillCheckup: it is read on your device, never uploaded, and the free check shows how many things are worth asking the billing office about, and names the first. The full list, with the exact questions to ask, is $6.99 for one bill, or included with Pro at $9.99 a month.
Check my bill, freeMedBillCheckup provides informational assistance only. It does not determine whether a charge is medically necessary, fraudulent, illegal, or definitively incorrect, and it is not a substitute for advice from a lawyer, doctor, insurer, or certified medical billing specialist.