The Hospital Bill
Health-Gen. § 19-214.1 — free care at 200% of poverty, and 240 days to apply
In Maryland, each acute care and chronic care hospital under the Commission's jurisdiction has a financial assistance policy for free and reduced-cost care to patients who lack coverage, or whose coverage does not pay the full bill.
- Free medically necessary care at or below 200% of the federal poverty level.
- Reduced-cost care above 200%: from 201% to 250%, out-of-pocket costs are cut by at least 75%, and above 250% up to 300%, by at least 60%.
- Reduced-cost care below 500% of the federal poverty level for a family with a financial hardship, meaning medical debt over a 12-month period that exceeds 25% of family income.
Presumed eligible. A patient not eligible for the Medical Assistance or children's health programs is presumptively eligible for free care if the household receives SNAP, energy assistance or WIC benefits, or has a child enrolled in free and reduced-cost meals based on household income.
240 days to apply. The hospital gives notice of its policy before discharge and in each communication about collecting the bill, stating that the patient has up to 240 days after receiving the initial hospital bill to apply. It considers any change in financial circumstances the patient reports within that period.
Assets and a second look. A hospital may consider only household monetary assets in excess of $100,000, excluding retirement accounts, and a denial can be reconsidered on request, with the Health Education and Advocacy Unit available to help.
| The assumption | What the law actually does |
|---|---|
| The assumptionAssistance is only for people with no income | What the law actually doesReduced-cost care reaches below 500% of the federal poverty level with a financial hardship |
| The assumptionThe chance to apply ends at discharge | What the law actually doesUp to 240 days after the initial hospital bill |
Insurance appeals, surprise billing rules and the federal rules for nonprofit hospitals are not all on this page. Whether a particular bill qualifies, or a particular collection step was allowed, is a question for a licensed Maryland attorney.
Sources for this section (1)
- Md. Code, Health-Gen. § 19-214.1 — Hospital financial assistance policies
Legal information, not legal advice. Verified as of October 2026. Applying it to a particular situation is the work of a licensed Maryland attorney.