Other LanguagesDepending on how much individuals and families make a year, Washingtonians can qualify for free or discounted care at hospitals in the state. These protections apply to out-of-pocket hospital costs, including co-pays and deductibles. This kind of financial assistance for hospital bills is known as “charity care.”
In 2022, the income requirements for charity care changed substantially, leading to thousands more Washingtonians becoming eligible for free or discounted hospital care under the new law. To see if you qualify for charity care, visit the Washington State Department of Health website to learn more about the law’s income requirements.
To receive charity care, you have to apply for it with the hospital. The charity care law sets a minimum requirement that hospitals must follow, but hospitals are allowed to be more generous with their policies (granting charity care to patients with higher incomes, for example). It is always a good idea to check with a financial counselor at the hospital where you received care to learn more.
If you think your hospital is not following the law, file a complaint with the Attorney General at https://www.atg.wa.gov/file-complaint.
FAQ
What is this program?
Washington’s charity care law requires that hospitals make financial assistance available for low-income patients to help with their out-of-pocket medical costs. That applies to people with or without health insurance. Many people face significant out-of-pocket costs even with insurance, and our charity care law helps those individuals.
Is there a minimum age requirement?
No. There is no minimum or maximum age requirement for eligibility. All Washingtonians are eligible.
Do you have to be on Medicare or Medicaid to use charity care?
No, charity care applies to all Washingtonians, whether they have public medical insurance, private medical insurance, or are uninsured. Charity care covers all or some of your out-of-pocket costs, regardless of insurance status, based on your income level alone.
Are there citizenship requirements to receive this support?
No, all patients can apply for charity care regardless of their immigration status.
Does receiving charity care impact my eligibility for Social Security, Medicare, or Medicaid?
It does not. Charity care applies to the part of your hospital bill that you pay, such as deductibles and copays. Medicaid and Medicare will still cover their share, and then charity care will apply to the remaining out-of-pocket amount.
Doesn’t Medicaid and/or Medicare pay for everything?
Not necessarily. There can be out-of-pocket costs associated with any hospital care depending on what is covered. That goes for private insurance, as well.
Why is there a charity care program?
Hospital bills are expensive. That’s why Washington has expansive eligibility for support.
Is this only for hospital care? What about clinic visits?
Charity care applies to medical care received at a hospital. However, sometimes hospitals that are associated with clinics will extend their charity care policy to those clinics. The best thing to do is always ask.
What types of visits and procedures at hospitals are covered by charity care?
Charity care applies to medical care received at a hospital. That includes emergency room care, as well as any other scan, test, or procedure done at a hospital. Charity care may not cover bills from physicians or other providers not employed by the hospitals.
Does charity care only apply to future bills, or does it apply to past bills as well?
Charity care applies to both future care and past bills. It does not matter how old the bills are, or whether they have been sent to collections. If you are eligible, charity care can apply to your hospital bill.
What is the difference between “Tier 1” and “Tier 2”?
Large, urban hospitals that represent 80 percent of hospital beds are in their own tier with more robust discounts. These larger hospitals are referred to as Tier 1. The smaller independent hospitals and rural hospitals — which represent about 20 percent of the beds around the state — are in Tier 2 and offer slightly smaller discounts. You can find a list of hospitals by tier on the state Department of Health website.
When I had hospital care, I received two different bills — one from the hospital, and one from the physician. Are both bills eligible for financial assistance under the charity care law?
Only hospitals are required to provide charity care. The statute does not require physician bills to be eligible. However, many hospitals do require that physicians who operate in their hospitals honor their charity care policies. Check with your hospital to see if they do.
What if I own a home, or have retirement accounts. Can those types of assets disqualify me?
Most importantly, hospitals cannot consider your ownership of your primary residence, or its value, when assessing charity care eligibility, so personal home ownership would have no impact on charity care. Hospitals can consider some assets in assessing eligibility, but the thresholds are high and most consumers who are income-qualified for charity care will not be excluded based on their assets.
Does charity care cover care for conditions like Alzheimer's?
Charity care applies to medical care received at a hospital. Eligibility is not determined by specific medical conditions. However, sometimes hospitals that are associated with clinics will extend their charity care policy to those clinics. The best thing to do is always ask.
How can a patient find out if they are eligible for financial assistance under Washington’s charity care law?
Visit the Washington State Department of Health website to learn more about qualifying income levels. You can also ask your hospital. But patients shouldn’t have to ask. Under state law, hospitals are required to provide notice of the availability of charity care to patients both verbally and in writing, and screen patients for charity care eligibility before attempting to collect payment from them for their out-of-pocket costs.
How is our eligibility determined?
The charity care regulations define family as “a group of two or more persons related by birth, marriage, or adoption who live together.” This means the incomes of adult family members living together can be considered in a charity care application. Always be sure to explain your individual situation to the hospital in your charity care application because hospitals may make exceptions based on individual circumstances.
What happens if hospitals don’t follow the state’s charity care law?
We want to hear from people if they’re having any difficulties. We have a team of attorneys working on this issue, and our office has filed lawsuits against hospitals for failing to ensure that eligible low-income Washingtonians receive the discounts to which they are legally entitled. We’re ready to take action if hospitals fail to meet their obligations. If you think your hospital is not following the law, file a complaint with us at https://www.atg.wa.gov/file-complaint.
How long has Washington required hospitals to provide financial assistance?
Washington’s original charity care legislation passed in 1989, so this assistance has been available to Washington patients for more than three decades.
Enforcement of Washington's Charity Care Law
The Attorney General’s Office (AGO) Consumer Protection Division has filed a number of successful lawsuits against hospitals in recent years related to charity care. The AGO has also successfully sued debt collection agencies for not informing patients about their rights related to medical debt.
- Renton Collections to provide Washingtonians $1.5 million in medical debt relief to settle AGO suit (April 13, 2026)
- Confluence Health refunds more than $1.8 million to patients following Attorney General’s investigation (Dec. 8, 2025)
- Judge orders Providence debt collector Optimum Outcomes to pay $827,000 penalty for violating patients’ medical debt collection rights (March 20, 2024)
- Providence debt collector Harris & Harris to pay $1 million for failing to inform patients of their medical debt collection rights (Feb. 21, 2024)
- Providence must provide $157.8 million in refunds and debt relief for unlawful medical charges to low-income Washingtonians (Feb. 1, 2024)
- PeaceHealth will return up to $13.4 million to patients who should have received financial assistance (Nov. 20, 2023)
(Updated April 13, 2026)