Massachusetts Hospital Charity Care & Financial Assistance

Massachusetts charity care law

Massachusetts Health Safety Net (M.G.L. c.118E; 101 CMR 613.00) requires free care for household incomes up to 150% FPL and discounted care up to 400% FPL, applying to acute care hospitals and community health centers (MA residents). Last verified 2026-07-10. Read the statute.

State minimums are a floor, not a ceiling: individual hospital policies are often more generous, and the hospital's Financial Assistance Policy makes the final determination.

How to choose the right kind of help

1. Start with the hospital that billed you. Find it in the table below and note its published income limit. Each hospital sets its own, so you may qualify at one and not another.
2. Free or discounted care: published limits on file in Massachusetts run from 200% to 400% of the Federal Poverty Level. At 200% that is about $31,920 a year for 1 person or $66,000 for a household of 4.
3. Discounted care above the free-care limit: 13 hospitals on file in Massachusetts also publish a higher limit for discounted care.
4. Massachusetts law: Massachusetts Health Safety Net requires free care up to 150% FPL and discounted care up to 400% FPL at acute care hospitals and community health centers (MA residents). A hospital's own policy can be more generous.
5. Income above these limits, or a balance left after a decision: ask the billing office whether it offers a payment plan, and get the terms in writing before you pay.
6. No insurance: check whether you qualify for Medicaid or a subsidized Marketplace plan at HealthCare.gov.

How to apply for hospital financial assistance in Massachusetts

1. Find the hospital that billed you in the table below and open its policy.
2. Check the income limit and the documents the policy asks for.
3. Get the financial assistance application online if the hospital posts one, or ask the billing office for it.
4. Submit it with the documents the policy lists, and keep copies. Nonprofit hospitals in Massachusetts must accept applications for at least 240 days from the first post-discharge bill under IRS Section 501(r).
5. If you are turned down, ask for the decision in writing and the reason.

Dollar For is a nonprofit that helps patients apply for hospital financial assistance for free.

Hospitals in Massachusetts with policies on file

Your rights under IRS Section 501(r)

Nonprofit hospitals must maintain a written Financial Assistance Policy, make it publicly available, limit charges for FAP-eligible patients to amounts generally billed to insured patients, and accept applications for at least 240 days after the first post-discharge billing statement. 501(r) does not set an income threshold; each hospital's own policy does, so patients may qualify at one hospital and not another. Many public and for-profit hospitals also maintain financial assistance policies, and in some states charity care is required by state law for all hospitals.