Medical bills in California: free care, credit reports and your rights
California has a law that requires hospitals to give free or discounted care to people with income up to 400% of the federal poverty level.
California law bans medical debt from credit reports.
Charity care means free or discounted care for people with low income. Hospitals also call it financial assistance.
Checked against official sources: October 30, 2026.
Federal rules for nonprofit hospitals apply in every state. Free help can review your bill.
Can I get my bill reduced in California?
California has a law that requires hospitals to give free or discounted care to people with income up to 400% of the federal poverty level.
| Income (% of poverty level) | What you get | Details |
|---|---|---|
| Up to 400% | Free or discounted care | If your family income is at or below 400% of the federal poverty level, you are eligible under the hospital's charity care (free care) policy or its discount payment policy. Each hospital's policy sets which incomes get free care and which get a discount. A hospital may also help people above 400%. |
These are the income levels written in the law. Each hospital decides using its own policy.
- The law
Hospital Fair Pricing Act
- Which hospitals
All licensed general acute care, acute psychiatric and special hospitals, including for-profit hospitals (not state hospitals or prison hospitals).
- Who can get help
Patients without insurance (self-pay), and insured patients with high medical costs: out-of-pocket costs at the hospital, or medical expenses in the last 12 months, above 10% of family income.
- The most you can be charged
If you qualify for a discount, the hospital can expect to be paid no more than what Medicare or Medi-Cal would pay for the service, whichever is greater.
- Deadline to apply
There is no time limit. A hospital may not set a deadline to apply or deny help because of when you applied.
- Find a hospital's policy
Law: Cal. Health & Safety Code 127400-127446 (esp. 127400, 127405, 127406, 127410, 127440)
Check your income level
Find out what percent of the federal poverty level your household income is, and compare it with the income levels in California law.
Is my debt too old in California?
| Kind of agreement | Time limit to sue |
|---|---|
| Written contract | 4 years |
| Open account | 4 years |
| Oral (spoken) agreement | 2 years |
A lawsuit on a written contract, a book account or an account stated must be filed within 4 years. On an oral contract, within 2 years. Once the 4-year period has run, no one may sue or start arbitration to collect the debt.
- What can restart the clock
A new promise to pay restarts or extends the time only if it is in writing and signed by you.
Law: Cal. Code Civ. Proc. 337, 339, 360
A time limit to sue can differ by kind of agreement, and when it starts and what restarts it can differ; a court decides.
Can they sue me or report it in California?
- Credit reports
Full ban
No one may report a medical debt to a credit bureau. If someone knowingly does, the debt becomes void and cannot be collected.
- Waiting rules
Wait before a lawsuit: 180 days after the first bill
A hospital, collection agency or debt buyer may not sue you over a hospital bill until 180 days after the first bill. This waiting period is extended while you have an insurance or Medi-Cal or Medicare appeal pending, if you keep the hospital informed. Before a hospital sends a bill to collections or sells it, it must send you a notice with the dates of service, who gets the bill, how to get an itemized bill, your insurance on file, and a financial assistance application.
- Interest
Hospital extended payment plans for patients who qualify for charity care or discounts must be interest free. A debt buyer that buys hospital debt must agree not to charge interest or fees.
- Liens on your home
For patients who qualify under the hospital's charity care or discount policy, the hospital and its affiliates may not use liens on real property, and outside collectors and debt buyers may not use liens on real property or sell your home, to collect a hospital bill.
- Wage garnishment
For patients who qualify, the hospital may not garnish wages. An outside collector or debt buyer may garnish wages only with a court order after a motion showing you can afford it. For other debts, at most the lesser of 20% of weekly disposable earnings or 40% of the amount above 48 times the minimum hourly wage can be taken.
- Selling the debt
A hospital may sell patient debt to a debt buyer only if it found you ineligible for financial assistance or you did not respond for 180 days, and the buyer is licensed, agrees not to resell it and not to charge interest or fees, and agrees to return the account if it turns out to be covered by insurance or eligible for charity care.
- Lawsuit rules
A debt collector suing on a hospital debt must state in the complaint that the debt came from a hospital, the hospital's financial-assistance notice dates, and the balance with any interest and fees added, and must attach the financial assistance application and notice the hospital sent. A default judgment cannot be entered without sworn business records showing these facts.
Law: Cal. Health & Safety Code 127425, 127426; Cal. Civ. Code 1788.14(e), 1788.185; Cal. Code Civ. Proc. 706.050
Payment plans and interest in California
- Hospitals must offer a payment plan
- Interest-free
- Monthly payment limit: 10% of your monthly income
A hospital's discount policy must include an extended payment plan. You and the hospital negotiate the terms based on your family income and essential living expenses. If you can't agree, monthly payments can be no more than 10% of your family's monthly income after essential living expenses (rent, food, utilities, child care, transportation and similar costs). The plan must be interest free. The hospital may end it only after you miss all payments due over 90 days, and only after trying to reach you by phone and in writing and offering to renegotiate.
Law: Cal. Health & Safety Code 127400(i), 127405(c), 127425(i)
Surprise bills and ambulance bills in California
- State law
California surprise billing law (AB 72) and ground ambulance law (AB 716)
- Which plans it covers
Health plans regulated by the state: plans licensed by the Department of Managed Health Care and health insurance regulated by the Department of Insurance.
- What it adds
If you go to an in-network hospital, lab, imaging center or other facility and are treated there by an out-of-network doctor or other professional, you pay only your in-network cost sharing.
- Ground ambulance
The state protects you
If your state-regulated plan covers the ride, an out-of-network ground ambulance can charge you only your in-network cost sharing (plans issued or renewed on or after January 1, 2024). If you are uninsured or self-pay, a ground ambulance may not charge you more than the Medi-Cal or Medicare fee-for-service rate, whichever is greater.
Law: Cal. Health & Safety Code 1371.56, 1797.233; Cal. Ins. Code 10126.66
Law: Cal. Health & Safety Code 1371.9, 1371.56; Cal. Ins. Code 10112.8, 10126.66
Itemized bills and price estimates in California
Before sending a hospital bill to collections or selling it, the hospital must tell you how to get an itemized bill. State law also lets you see the hospital's full list of charges (charge description master) on its website or at the hospital.
Law: Cal. Health & Safety Code 127425(e)(3), 1339.51
Price estimates
If you don't have health coverage, a hospital must give you a written estimate of what it will require you to pay for expected services, with its financial assistance policy and an application form (not for emergency care).
Law: Cal. Health & Safety Code 1339.585
Health coverage and Medicaid in California
Medi-Cal is California's Medicaid program. Apply for it here:
Where to complain in California
- Hospital bills and financial assistance: Department of Health Care Access and Information (HCAI), Hospital Bill Complaint Program
A hospital wrongly denied you charity care or a discount, did not give the required notices, or did not follow the rules before sending your bill to collections. It does not handle general billing or price disputes. - Health plan problems: Department of Managed Health Care (DMHC) Help Center
Problems with an HMO or other plan licensed by DMHC, including surprise bills and denials. - Health insurance: California Department of Insurance · 1-800-927-4357
Problems with a health insurance policy regulated by the Department of Insurance. - Debt collectors: Department of Financial Protection and Innovation (DFPI) · 1-866-275-2677
A debt collector or debt buyer broke state collection rules. - Attorney general: California Attorney General, Public Inquiry Unit
Other consumer complaints against a business.
Free help in California
Free tools, letters and checklist
Good to know in California
- California's financial assistance rules apply to for-profit hospitals too, not only nonprofit hospitals.
Law: Cal. Health & Safety Code 127400(d)
- Hospitals must file their charity care, discount and debt collection policies with HCAI, which posts them online, and you cannot be denied help available under the policy posted when you were first billed.
Law: Cal. Health & Safety Code 127435
- HCAI can fine a hospital up to $40,000 per violation and must tell you if you are owed a refund.
Law: Cal. Health & Safety Code 127436, 127440
Changes in 2024–2026
January 1, 2025: SB 1061 (2024) banned reporting medical debt to credit bureaus and barred lenders from using it; AB 2297 (2024) banned asset tests and application deadlines for hospital financial assistance. January 1, 2026: AB 1521 (2025) amended the credit-reporting law; SB 862 (2025) added a link to the hospital's shoppable-services list to the required notice. AB 1312 (2025) added presumptive eligibility and required screening starting July 1, 2027. June 29, 2026: SB 164 created a Hospital Fair Pricing Penalties Fund (127437).
Law: Civ. Code 1785.27; Health & Safety Code 127406
Questions about medical bills in California
Does California require hospitals to give free or discounted care?
California has a law that requires hospitals to give free or discounted care to people with income up to 400% of the federal poverty level.
Can medical debt be reported to credit bureaus in California?
California law bans medical debt from credit reports. No one may report a medical debt to a credit bureau. If someone knowingly does, the debt becomes void and cannot be collected.
How long can a medical bill be collected or sued on in California?
A lawsuit on a written contract, a book account or an account stated must be filed within 4 years. On an oral contract, within 2 years.
Can a medical debt lead to wage garnishment or a lien on my home in California?
For patients who qualify, the hospital may not garnish wages. An outside collector or debt buyer may garnish wages only with a court order after a motion showing you can afford it.
Am I protected from ground ambulance bills in California?
If your state-regulated plan covers the ride, an out-of-network ground ambulance can charge you only your in-network cost sharing (plans issued or renewed on or after January 1, 2024). If you are uninsured or self-pay, a ground ambulance may not charge you more than the Medi-Cal or Medicare fee-for-service rate, whichever is greater.
Can I get a payment plan for a hospital bill in California?
A hospital's discount policy must include an extended payment plan. You and the hospital negotiate the terms based on your family income and essential living expenses.
More help
Nearby states
Sources
- Cal. Health & Safety Code 127400-127446, Hospital Fair Pricing (official Legislative Counsel text, bulk file of Oct. 26, 2026)
- Cal. Health & Safety Code 127450-127462, emergency physician discounts
- Cal. Civ. Code 1785.27 (medical debt credit reporting)
- Cal. Civ. Code 1788.14, 1788.185 (hospital debt collection and lawsuits)
- Cal. Health & Safety Code 1371.9, 1371.56, 1797.233; Ins. Code 10112.8, 10126.66 (surprise bills, ground ambulance)
- Cal. Code Civ. Proc. 337, 339, 706.050
- HCAI Hospital Bill Complaint Program
- HCAI Hospital Fair Billing Program
- California Department of Insurance consumer help
- DFPI: Submit a complaint
- Legislative Counsel bulk data (pubinfo_2025.zip)