The Hospital Bill
ORC 5168.14 — free care a hospital owes rather than offers
There is a provision in Ohio law that most people who could use it have never heard of, and the reason it goes unused is the word charity. It is not charity. It is a condition a hospital accepted in exchange for program money, and the section says shall.
Who handles this in Ohio: legal aid programs, lawyer referral and the state offices, listed in the Ohio directory.
A hospital taking the program payment owes the care, without charge. Each hospital that receives payment under the program has to provide, without charge, basic and medically necessary hospital level services to a person who is an Ohio resident, who is not a Medicaid recipient, and whose income is at or below the federal poverty guidelines. Those are the whole of the conditions. Not a hardship panel, not a discretion, not a discount off a list price.
| The condition | What it means |
|---|---|
| The conditionAn Ohio resident | What it meansResidence, not citizenship or immigration status |
| The conditionNot receiving Medicaid | What it meansThe program sits beside Medicaid rather than inside it |
| The conditionIncome at or below the federal poverty guidelines | What it meansThe figures are published annually and change with household size |
| The conditionBasic, medically necessary, hospital level services | What it meansWhat the section covers, rather than everything a hospital can bill for |
The application goes through the hospital that provided the care rather than through a state office, and each hospital administers its own. That is worth knowing because it means the people to ask are in the billing department of the building somebody was treated in.
A bill arriving does not mean the question was asked. Nothing in the section makes a hospital work out on its own whether a patient qualifies before it bills them. A bill, a payment plan offer, and a collections letter can all arrive without anybody ever having checked. The bill is the hospital's opening position rather than a finding about eligibility.
“Does this hospital take program payment, and how is an application made here.”
Hospitals commonly run their own financial assistance policies alongside this, reaching incomes above the poverty guidelines on their own terms, and those are the hospital's rules rather than the section's. Physician and ambulance bills are frequently separate from the hospital's own bill and are not covered by it. What a particular hospital requires, what counts as basic and medically necessary, and what can be done about a bill already in collections are questions for a licensed Ohio attorney or a hospital financial counselor, and legal aid offices across the state handle medical debt.
Sources for this section (2)
- ORC 5168.14 — The care a hospital taking program payment has to provide without charge
- Hospital Care Assurance Program — Ohio Department of Medicaid, the program that pays hospitals for the free care the section requires
Legal information, not legal advice. Verified as of September 2026. Applying it to a particular situation is the work of a licensed Ohio attorney.