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Understanding Hospital Charity Programs and How They Can Help You

The cost of medical care can be overwhelming for many Americans. According to a September 2020 Gallup poll, half of Americans fear a major health crisis could lead to bankruptcy. Additionally, 26% of Americans reported delaying medical treatment in the prior 12 months due to high costs. If you’re postponing essential medical care or struggling to pay a hospital bill, charity care might be a solution for you. Charity care provides free or discounted medical services to those who cannot afford to pay. Here’s a closer look at how these programs work and who may qualify.

How Do Hospital Charity Programs Work?

Charity care offers free or discounted medically necessary health care to individuals who cannot afford treatment. This includes both inpatient and emergency room services. Even if you have health insurance, you might qualify for charity care to cover the portion of your hospital bill that insurance doesn’t pay.

Under the Affordable Care Act (ACA), nonprofit hospitals must offer charity care to maintain their nonprofit status with the IRS. However, hospitals can set their own rules regarding eligibility, and some are more generous than others. Some states have laws requiring health care providers to offer charity care, and many for-profit hospitals also have needs-based programs.

Eligibility for charity care varies depending on your location and the hospital. Policies may have exclusions, such as services provided by non-hospital employees.

How Do I Get Charity Care?

Nonprofit hospitals are required to provide information about their charity care programs in various ways, such as posting information in waiting areas, providing details during check-in or discharge, or including it with your bill. Each hospital handles the process differently. Some assess your eligibility upon check-in, while others include information in your discharge papers or bill. If you don’t receive information, visit the hospital’s website or contact the billing department for details and application forms.

Charity care is intended to be used after payments from other sources, such as health insurance or Medicaid, have been applied. Some providers offer assistance only to uninsured patients, while others may provide partial assistance to insured patients. Hospitals may first try to enroll patients in state Medicaid programs before directing them to a charity application.

To determine eligibility, hospitals require documentation to verify your income, such as W-2 statements, pay stubs, tax returns, unemployment benefits statements, Social Security benefit statements, or documentation from your state’s social services department. Financial counselors or navigators can assist you through the process.

The approval process typically takes two to six weeks, depending on the provider’s backlog and the completeness of your documentation. You’ll receive a letter stating whether your application was approved or denied, along with instructions on how to appeal if necessary.

Apply for charity care as soon as possible, as medical debt is handled differently than other debt. Unpaid medical bills are not reported to credit bureaus until they are sent to collections, typically 90 days past due. Even then, the main credit bureaus will not show the delinquent account for a year after the bill was due or if the balance is under $500. However, unpaid bills over $500 can negatively affect your credit score, and the hospital might sue to get paid.

It’s never too late to apply for charity care, even if your bill has gone to collections or you’ve been served with a lawsuit. If you qualify, you may be refunded any money that charity care covers.

Other Organizations That Can Help Pay for Medical Bills

If you don’t qualify for charity care or Medicaid, or if you still struggle to afford copays or medication, other options are available. Hospital staff may not have time to help you find these resources, so you’ll need to do some research on your own.

Programs may be available in your state for specific diseases or health conditions. You can also search online for local or private organizations offering financial assistance. Here are a few organizations to get you started:

• CancerCare: Provides copay assistance for patients with certain cancer diagnoses.
• Good Days: Helps patients pay for life-extending treatments, diagnostic tests, insurance premiums, copays, and more.
• HealthWell Foundation: Assists with copays, premiums, medication, and other out-of-pocket costs.
• Leukemia & Lymphoma Society: Provides financial aid for patients with those diseases.
• Medicine Assistance Tool: Matches you with resources and programs to reduce out-of-pocket costs for prescription medication.
• NeedyMeds: Helps people find sources of assistance to pay for medication and medical care.
• PAN Foundation: Provides financial assistance with out-of-pocket medical expenses, including copays and medication.

If you’re struggling to afford expensive medication, look for pharmaceutical company patient assistance programs (PAPs). Drug manufacturers may provide a PAP for uninsured, underinsured, or low-income patients, or offer discount coupons regardless of income.

Keep Your Credit Healthy

Receiving a large medical bill you can’t afford is daunting, but resources are available to help. Find out what financial assistance the hospital can offer and research alternatives such as state assistance and private organizations. Discuss payment options with the hospital’s billing department, such as setting up a payment plan.

Paying a medical bill can take time, especially if insurance or charitable sources are involved. Monitor your account and stay in touch with the hospital to ensure everything is progressing smoothly. Regularly check your credit report and score to ensure they aren’t negatively impacted.

Don’t ignore a medical bill and hope it goes away. Taking action as soon as possible can help protect your credit score.

For any mortgage-related needs, call O1ne Mortgage at 213-732-3074. We’re here to help you navigate your financial journey with confidence.

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