What the 38 policies say
- 35 say in plain words that patients with insurance may get help. The other 3 (Baylor Scott & White Health, Corewell Health and OhioHealth) do not say so in plain words: their rows below show what they do say.
- 14 of the 35 name copays, deductibles or coinsurance as costs help may cover. The other 21 speak more generally of insured or underinsured patients, or of what is left after insurance.
- 24 of the 35 say insurance must be billed or used first, or make your insurance details, or cooperating on insurance, a condition.
- 19 of the 35 say out-of-network care, the insurer’s rules or its contract may reduce or rule out help.
- 8 of the 35 give patients with insurance a lower income limit, or an extra test that patients without insurance do not face, such as costs above a share of income. A smaller discount alone is not counted.
Each row below shows which of these counts it is in, so you can rebuild any of them.
What this count does not tell you
It counts what the policies say, not who gets approved. We did not see who applied or how often they were approved. The hospital decides, using its own form and its own way of counting income.
These 38 are large nonprofit systems we chose to read, not a sample of US hospitals, so the share at other hospitals may differ. We left out 8 other large systems because their sites blocked our reading tools: Novant Health, Intermountain Health, Sutter Health, AdventHealth, Geisinger, Prisma Health, Johns Hopkins Medicine and Penn Medicine.
Federal rules make a nonprofit hospital publish its financial assistance policy, but they leave who qualifies to the hospital. Some states go further: see the state rules.
Can’t afford a hospital bill even with insurance?
- Keep the Explanation of Benefits from your insurer. It shows what insurance left for you to pay.
- Ask the hospital for its financial assistance policy, the application and the plain language summary. The free financial assistance letter asks for all three.
- Look in the policy for “underinsured”, “copay” or “deductible”, and for whether the hospital must be in your plan’s network.
- See where your income may fall on the list of income limits. It runs on your device, and nothing you type is sent. Patients with insurance may face a lower limit, so check your hospital’s row below too.
- Apply as soon as you can, even if you are not sure. Asking costs nothing, and nonprofit hospitals must accept applications for at least 240 days after the first bill sent after you leave.
Policy by policy
| Health system | What the policy says | Source |
|---|---|---|
| Advocate Health | Patients with insurance in a listed state may get 100% off the self-pay balance at incomes up to 300% of the guidelines, if care was in network (emergency visits excepted) and they cooperated with their insurer. Without insurance, discounts reach higher incomes.Counted in the 35: insurance first, plan rules, lower limit or extra test. | Advocate Health Financial Assistance Policy, pages 4 and 6 |
| Ascension | In the Austin, Texas policy, help applies to what you owe after your insurer pays. It may be reduced or denied if your plan treats the hospital as out of network, or if you refuse to assign insurance payments to the hospital.Counted in the 35: insurance first, plan rules. | Financial Assistance Policy, Ascension Seton (Austin, Texas), pages 3, 4 and 6 |
| Banner Health | Underinsured patients may get 50% to 100% off the balance after insurance, such as deductibles and copays, at incomes up to 400% of the guidelines. Care that is out of network, or claims the insurer denied, is first billed at the self-pay rate.Counted in the 35: names the costs. | Banner Health Financial Assistance Policy for Hospital Patients (Policy 770, Version 6), pages 2 to 5 and 8 |
| Baylor Scott & White Health | The policy does not name patients with insurance. Its discounts apply to the balance after all third parties pay, and a patient must first use other payment options, including private coverage, or help may be denied.Not counted in the 35. | Financial Assistance (Hospital Facilities), Document Number BSWH.FIN.RC.BA.36.P, pages 2, 4 and 5 |
| Bon Secours Mercy Health | Patients with only partial insurance may qualify, and balances from deductibles, copays and coinsurance may get a discount based on household income. They must supply the information needed to settle claims, such as coordination of benefits.Counted in the 35: names the costs, insurance first. | Healthcare Financial Assistance (HFA), Policy and Procedure 502, Version 7.0, pages 1, 5, 6 and 14 |
| Cedars-Sinai | Underinsured patients may get free care at incomes up to 400% of the guidelines, and a smaller discount than patients without insurance from 401% to 600%. Approved patients must give the information needed to seek payment from third parties.Counted in the 35: insurance first. | Financial Assistance Policy, pages 2, 13 and 18 |
| CHRISTUS Health | The balance after insurance, such as coinsurance, deductibles and copays, may qualify at the same income levels. Patients must follow their plan’s referral, authorization and network rules, and accounts with a liable third party may be left out.Counted in the 35: names the costs, insurance first, plan rules. | Financial Assistance Policy (system wide), pages 1, 4, 5 and 6 |
| Cleveland Clinic | Patients with insurance may get limited help, mainly when the balance due is above 25% of income. The hospital must be in network, with narrow exceptions, and the patient must have met the insurer’s requirements.Counted in the 35: insurance first, plan rules, lower limit or extra test. | Financial Assistance Policy (Cleveland Clinic Health System, Ohio and Nevada), pages 2 and 3 |
| CommonSpirit Health | Underinsured patients may qualify, and help applies to the balance left after other payers. Insured patients are offered help only as far as their insurance contract allows, and must first use other payment options, including private coverage.Counted in the 35: insurance first, plan rules. | CommonSpirit Health Governance Policy, Finance G-003, Financial Assistance, pages 5, 6, 8 and 9 |
| Corewell Health | The main policy does not say so in plain words. It says everyone who applies goes through the same process whatever their primary payer, and that other payment sources, including insurance, are to be pursued first.Not counted in the 35. | Financial Assistance Eligibility Policy (Policy Reference #2983, Version 11), pages 3 and 5 |
| Duke Health | 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.Counted in the 35: plan rules. | DUHS Financial Assistance Policy, pages 1, 4, 5 and 9 |
| Emory Healthcare | With insurance, copays, deductibles and coinsurance may be fully written off at incomes up to 200% of the guidelines (350% without insurance); above 225% only case-by-case review applies, after other coverage has paid. A third-party injury settlement must go to the account and may end eligibility.Counted in the 35: names the costs, insurance first, lower limit or extra test. | Emory Healthcare Financial Assistance Policy, pages 5, 8, 9 and 11 |
| Henry Ford Health | Copays, deductibles and coinsurance may be discounted 25% to 100% at incomes up to 400% of the guidelines, for residents of its service area with assets under $100,000. Medicaid may have to be applied for first.Counted in the 35: names the costs. | HFH Patient Financial Assistance Policy, pages 2 to 4 |
| Houston Methodist | Underinsured patients may get help on the same income scale as everyone: free care up to 200% of the guidelines, discounts above it, and above 500% only when the balance passes 10% of income.Counted in the 35. | Policy FI49 Financial Assistance, pages 2, 5 and 7 |
| Kaiser Permanente | Eligible patients with coverage may get help with what insurance leaves, such as copays, coinsurance and deductibles. They must give documentation such as an Explanation of Benefits, appeal denied claims to the insurer, and sign over insurer payments.Counted in the 35: names the costs, insurance first. | Kaiser Permanente Medical Financial Assistance policy, NATL.CB.307, with the Northern California addendum, pages 15, 16 and 17 |
| Mass General Brigham | Underinsured patients who live in Massachusetts or New Hampshire may get help with copays, coinsurance and deductibles if income or medical costs fit. Insurance is billed first, and care is typically left out if they knew their plan would not cover it and could have gone elsewhere.Counted in the 35: names the costs, insurance first, plan rules. | Financial Assistance Policy / Uninsured Patient Discount Policy, Fiscal Year 2026, pages 3, 6, 8, 9, 10 and 15 |
| Mayo Clinic | Underinsured patients may apply for help with the self-pay balance left after other payment options, and must let Mayo submit claims. Help is generally not available if Mayo is out of network, except for emergency department care or treatment unique to Mayo.Counted in the 35: insurance first, plan rules. | Financial Assistance Policy, Mayo Clinic and Affiliated Hospitals and Clinics in Minnesota (form MC5815-03rev0924), pages 1 to 3 |
| Memorial Hermann | Insured patients may apply, and must have their insurance billed first. Underinsured patients may have what they owe cut to the amount generally billed at 200% to 400% of the guidelines; free care is written for uninsured patients.Counted in the 35: insurance first. | Financial Assistance Policy (Version 5), page 6 |
| Mercy (St. Louis) | Patients with insurance may apply, and help may apply to what they owe after other payers have paid, if they follow their plan’s rules.Counted in the 35: insurance first, plan rules. | MRC PSERV Financial Assistance Program Policy_Hospital and Health Services (Version 41), pages 4 and 5 |
| Mount Sinai Health System | Underinsured patients may be eligible, including for deductibles and copays, under New York law. The policy’s general income limit is 400% of the guidelines, and help is not available if they refuse their insurer’s requirements.Counted in the 35: names the costs, insurance first, plan rules. | Mount Sinai Hospitals Group Financial Assistance and Billing and Collections Policy, pages 2 and 4 |
| NewYork-Presbyterian | Patients facing extraordinary costs such as copays, deductibles or coinsurance, or who have used up benefits including health savings accounts, may get help below 600% of the guidelines, on the same scales as uninsured patients. Medicaid screening may come first.Counted in the 35: names the costs. | Financial Aid Policy (C106), pages 1, 2, 4 and 5 |
| Northwell Health | Underinsured patients may get help with deductibles, copays and coinsurance if their out-of-pocket costs passed 10% of income in 12 months and their income fits.Counted in the 35: names the costs, lower limit or extra test. | Financial Assistance Policy and Procedures (System Policy #300.20), pages 2, 4 and 6 |
| Northwestern Medicine | Illinois residents with insurance may have coinsurance and deductibles cancelled at incomes up to 250% of the guidelines, after insurance benefits are exhausted. Copays and out-of-network care are left out.Counted in the 35: names the costs, insurance first, plan rules. | Financial Assistance (Policy FIN 03.0012), pages 4, 13 and 14 |
| NYU Langone Health | The policy refers to eligible patients with insurance, and its state report counts their deductibles and coinsurance. Eligibility rests on income and family size. Help is denied if they skip public programs or billing steps. Elective care is excluded when the plan will not pay out-of-network.Counted in the 35: insurance first, plan rules. | Charity Care and Financial Assistance (NYU Langone Hospitals), pages 1, 2, 5 and 8 |
| Ochsner Health | Underinsured patients may qualify, and help applies to what they owe after insurance, such as deductibles, copays and coinsurance. Out-of-network care is excluded unless it is an emergency, or the insurer only says so after the care.Counted in the 35: names the costs, plan rules. | Financial Assistance (OHS.REV.042), pages 2, 3 and 5 |
| OhioHealth | The charity rules do not mention insurance; only the state HCAP program names the uninsured. Help is a last resort, so any other resource able to pay or reimburse the care must be used up first.Not counted in the 35. | Financial Assistance Policy (RC-2410.004), page 1 |
| Providence | This Washington policy says patients with insurance may get help too, including with coinsurance, deductibles and copays and with out-of-network charges, if they meet its income rules.Counted in the 35: names the costs. | Providence Financial Assistance (Charity Care) Policy, Washington (PSJH RCM 002 WA), pages 2 and 9 |
| Sanford Health | Patients may qualify with or without insurance, at the same income levels, once insurance and other payers have paid. Balances from not following an insurer’s requirements may be left out.Counted in the 35: insurance first, plan rules. | Financial Assistance - Enterprise (Sanford Policy, Patient Financial Services), pages 4 and 5 |
| Scripps Health | Patients whose insurance covers only part of the bill may get help, including when out-of-pocket costs after insurance pass 10% of family income. They must make every reasonable effort to give their coverage details.Counted in the 35: insurance first. | Patient Financial Assistance, Including Discounted Payments, and Charity Care (FAP), pages 1, 2 and 3 |
| Sentara Health | Patients with insurance may have the balance after insurance cancelled at incomes up to 300% of the guidelines with assets under $50,000, unless they skipped insurer requirements or have a third-party claim. Patients without insurance may get a discount up to 400%.Counted in the 35: insurance first, plan rules, lower limit or extra test. | Financial Assistance Policy (#2247), page 4 |
| Sharp HealthCare | Patients with insurance and income up to 400% of the guidelines may have hospital charges fully written off when their unreimbursed out-of-pocket medical costs over 12 months pass 10% of family income.Counted in the 35: lower limit or extra test. | Patient Financial Assistance Policy (Charity Care and Discounted Payment Program), 15602.99, pages 5 and 7 |
| SSM Health | Patients with some insurance but unaffordable costs may qualify, with the discount applied after insurance. Non-emergency out-of-network care may be excluded if an in-network provider in the area can offer it. Insurer payments sent to the patient must be repaid.Counted in the 35: insurance first, plan rules. | Operations - Financial Assistance Policy (Charity Care), pages 4, 5, 7 and 8 |
| Stanford Health Care | Patients with insurance at incomes up to 400% of the guidelines may have what they owe cancelled when their out-of-pocket medical costs pass 10% of income. They must make every reasonable effort to give their coverage details.Counted in the 35: insurance first, lower limit or extra test. | Financial Assistance Policy, pages 5, 7 and 14 |
| Texas Health Resources | The balance after insurance may be reduced if the patient cannot pay it. Insurance comes first, and above 250% of the guidelines the balance must pass a share of income.Counted in the 35: insurance first. | Financial Assistance Policy (system policy), pages 2, 3 and 13 |
| Trinity Health | Patients with insurance from an insurer the hospital contracts with, and income up to 400% of the guidelines, may get help with copays, deductibles and coinsurance, unless the insurer’s contract prevents it.Counted in the 35: names the costs, plan rules. | Trinity Health Finance Policy No. 1, Financial Assistance to Patients, as posted by Loyola Medicine, page 2 |
| UCHealth | Residents with insurance and unaffordable out-of-pocket costs may get discounts up to 400% of the guidelines, or when a single account balance after insurance exceeds half of income plus savings. Care a third party must pay is excluded.Counted in the 35. | UCHealth Financial Assistance Policy, pages 1, 2 and 7 |
| UF Health | Patients with insurance may get help with the balance after insurance at incomes up to 200% of the guidelines. Help may be denied if they do not follow insurer requirements or have a reference-based pricing plan.Counted in the 35: insurance first, plan rules. | Financial Assistance (Policy SYS-RCM-001), section 1.1 |
| UPMC | Underinsured patients at incomes up to 300% of the guidelines may owe nothing after insurance. Above that, hardship help may be considered, such as when costs pass 15% of income. It is typically denied if insurance rules were not followed.Counted in the 35: insurance first, plan rules, lower limit or extra test. | Financial Assistance Process, Policy HS-RE0722 (Pennsylvania version HS-RE0722-PA), pages 4, 6 and 7 |
How we read them
We used AI reading tools for this one question, and you can check any row yourself: each links to the policy and names the page. Two tools read each policy separately. A third settled the details where they differed, and final passes compared every sentence and every count here with the policy’s text. These tools never read anyone’s bill.
We count a policy only when its own words cover patients with insurance, so a policy that only implies it is not counted. Having to apply for Medicaid or another public program first is not counted as insurance first. MedBillCheckup is not part of any of these health systems. Some systems publish a separate policy for each state or market, so yours may differ from the one linked here. Our reading tools could not open Banner Health’s site on the day we read the others, so its row uses the copy of its policy we read on November 1, 2026, which may have changed since.
Quoting these figures
You are welcome to quote them. Please link to this page, and keep the word “may”: a policy that allows help is not a promise of help. A correction? Tell us on the Support page.
MedBillCheckup, “Can you get hospital financial assistance if you have insurance?”, policies read November 7, 2026 (Banner Health: November 1, 2026). https://medbillcheckup.com/hospital-financial-assistance/with-insurance
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.
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