Hospital Bill Help in California

If you're new to this, start with how to check and lower a medical bill.

A hospital bill you can't pay is scary. California's Hospital Fair Pricing Act makes hospitals offer free or discounted care to patients who cannot pay their bills. Each hospital runs its own program and uses its own form. The state Department of Health Care Access and Information (HCAI) enforces the rules and takes complaints.

You may qualify if

• You got care at a California hospital.
• Your family income is at or below $63,840 a year for one person, or $86,560 for two, in 2026.
• You have no insurance, or your medical costs are high, and having Medicare doesn't rule you out.

Not sure you qualify? Apply anyway, because the hospital makes the call and you can apply at any time. If you would rather not do it alone, a Pair Team advocate can help you apply.

What California hospitals must offer

Assembly Bill 1020, a 2021 law, raised the income line from 350% to 400% of the poverty level starting in 2022.

What counts as high medical costs?

High medical costs means you paid over 10% of your family income for care at that hospital in the last 12 months. Bills you paid to other doctors count too, if you show proof. The law names Medicare copays as one of these costs. If your family makes $30,000 a year, paying more than $3,000 yourself can count.

What changed in 2025, and what changes in 2027?

Assembly Bill 2297 and Senate Bill 1061 took effect on January 1, 2025:

• The hospital cannot count money in the bank to decide if you qualify. To waive Medicare copays, it may look at savings above a high federal limit, but retirement accounts never count.
• There's no deadline to apply.
• The hospital cannot make you apply for Medi-Cal or Medicare first.
• If you qualify, no one may put a lien on your home, or sell it, to collect a hospital bill.

From July 1, 2027, Assembly Bill 1312 makes hospitals check if your family gets certain other help. Examples are CalFresh, California Alternate Rates for Energy (CARE) and the Low Income Home Energy Assistance Program (LIHEAP). If your family gets help like this, the hospital must treat you as qualified.

How to apply at any hospital

1. Call the billing office and ask for the financial assistance application. Every hospital's policy and form is also on HCAI's policy lookup page.
2. Send proof of income: a recent tax return or pay stubs is all the law lets a hospital require. If you have neither, ask if it will take your Social Security letter.
3. Apply for the emergency doctor's bill too. It often comes from a separate group with its own discount policy.
4. Tell the hospital you applied, and ask it to hold the bill while it decides. It must send you a letter with its answer.
5. If you're turned down, ask the hospital's business manager or finance chief to review it. Then complain to HCAI.

For free help, call the Health Consumer Alliance at 1-888-804-3536. You can also call the Health Insurance Counseling and Advocacy Program (HICAP) at 1-800-434-0222. HICAP is California's free counseling for Medicare questions.

Limits on collecting a hospital bill

• Lawsuits wait 180 days. A hospital or collector cannot sue you for at least 180 days after the first bill.
• Payment plans have no interest for people who get charity care or a discount. If you can't agree, payments are capped at 10% of your family's monthly income after basic costs like rent and food.
• You get time to catch up. A plan can't be called broken until you miss 90 days of payments. First the hospital must call you, write to you, and offer to change the plan.
• The hospital can't garnish your wages if you qualify. An outside collector needs a court order.
• Medical debt stays off credit reports. Under Senate Bill 1061, no one may report a medical debt to a credit bureau. A debt that is knowingly reported cannot be collected. On November 13, 2025, the Attorney General said this is still the law in California.

Where to complain

File with HCAI's Hospital Bill Complaint Program online. Or mail it to HCAI, 2020 West El Camino Avenue, Suite 1101, Sacramento, CA 95833. For HCAI to look at a denial, you must have applied to the hospital first. HCAI does not handle general price disputes or the emergency doctor's bill. If you paid more than you should have, you may get a refund with interest.

What a Pair Team advocate does

When a California patient calls us about a hospital bill, Medi-Cal forms and the power bill often come up too. This is what we do:

• Call the billing office with you and ask for the financial assistance form.
• Gather your income papers, fill out the form, and follow up until the hospital decides.
• Check if you can get the Qualified Medicare Beneficiary (QMB) program or Medi-Cal. Either one can pay your copays from now on.
• Help with what usually comes with it: CARE and LIHEAP, CalFresh, Medi-Cal and rides.

An advocate is covered by Medicare if you qualify. It takes two minutes to find out.

Check if you qualify for a Pair Team advocate

Frequently asked questions

Is a discount the same as free care?

No, with a discount you still owe part of the bill, but charity care means free care. You can apply for both at once.

Can I apply after the bill went to collections?

Yes, you can apply even after a bill went to a collector, HCAI says. Send the form to the hospital, and tell the collector you applied.

Do small rural hospitals use the same income line?

The law lets rural hospitals set a lower line than 400% of the poverty level, so ask for the policy.

I have QMB or Medi-Cal. Can the hospital bill me?

With QMB, no one may bill you for Medicare copays or deductibles. See California Medicare Savings Programs. If you have Medi-Cal too, ask the billing office to bill Medi-Cal.

A medical bill is on my credit report. What do I do?

Tell the provider, the collector and the credit bureau, and ask them to remove it. If it stays, file a complaint with the Attorney General at oag.ca.gov/report. You can check your credit reports for free at 1-877-322-8228.

Sources

• Hospital Fair Billing Program, HCAI
• Hospital Fair Billing Program Laws and Regulations, HCAI
• Hospital Bill Complaint Program, HCAI
• Hospital Bill Complaint Program Frequently Asked Questions, HCAI
• Health and Safety Code section 127400, California Legislative Information
• Health and Safety Code section 127405, California Legislative Information
• Health and Safety Code section 127425, California Legislative Information
• AB 1312, Hospital pricing, California Legislative Information
• SB 1061, Consumer debt: medical debt, California Legislative Information
• In California, It Remains Illegal for Medical Debt to Appear on Credit Reports, California Attorney General
• Hospital financial assistance (2026 federal poverty levels), New York Attorney General
• Health Consumer Alliance