The Hospital Bill
RCW 70.170.060 — charity care by income, with full coverage at 200 or 300 percent of poverty
In Washington, each hospital maintains a charity care policy giving indigent persons access to charity care, including steps to identify patients who may qualify for medical assistance or the health benefit exchange and to help them apply.
At a health system with three or more acute hospitals, and at the largest hospitals the section names, charity care follows income.
- Not more than 300 percent of the federal poverty level: the full patient responsibility portion is charity care.
- Between 301 and 350 percent: a 75 percent discount.
- Between 351 and 400 percent: a 50 percent discount.
At other hospitals: not more than 200 percent of the federal poverty level is full charity care, 201 to 250 percent is a 75 percent discount, and 251 to 300 percent is a 50 percent discount.
Assets a hospital cannot count. If a hospital considers assets, it excludes the first $5,000 of monetary assets for an individual or $8,000 for a family of two, plus $1,500 for each additional family member; any equity in a primary residence; retirement plans other than 401(k) plans; one vehicle, and a second if needed for work or medical purposes; a prepaid burial contract or plot; and life insurance with a face value of $10,000 or less.
No unreasonable burden. Application procedures may not place an unreasonable burden on the patient, and requiring an application to a program the patient is obviously ineligible for, or was found ineligible for in the prior 12 months, is one. No hospital may deny access to emergency care based on ability to pay.
| The assumption | What the law actually does |
|---|---|
| The assumptionCharity care is only for the very poorest | What the law actually doesFull charity care reaches 200 or 300 percent of the federal poverty level, with discounts above |
| The assumptionOwning a home rules out help | What the law actually doesEquity in a primary residence is excluded when assets are considered |
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 Washington attorney.
Sources for this section (1)
- RCW 70.170.060 — Charity care — Prohibited and required hospital practices and policies
Legal information, not legal advice. Verified as of September 2026. Applying it to a particular situation is the work of a licensed Washington attorney.