Charity care in California: who gets 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.
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.
What the law says in California
| 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.
- Rural hospitals
Rural hospitals (as defined in state law) may set income levels lower than 400% of the poverty level to keep the hospital financially stable.
- 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.
- Savings and other assets
Not allowed. A hospital may not consider your money or other assets when deciding whether you qualify (a narrow exception applies when it waives Medicare cost sharing).
- Who counts as your family
Your family means your spouse or domestic partner and dependent children under 21 (or any age if disabled); for a minor, the parents or caretaker relatives and their dependent children.
Law: Cal. Health & Safety Code 127400-127446 (esp. 127400, 127405, 127406, 127410, 127440)
How to apply in California
- 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.
- Screening for help
Starting July 1, 2027, hospitals must screen uninsured patients, Medi-Cal patients with cost sharing and Covered California patients for financial assistance without a separate application, and must treat you as eligible if you or a family member is enrolled in programs such as CalFresh, CalWORKs, WIC, CARE, LIHEAP or a Housing Choice Voucher, if you were approved in the last 6 months, or if you are experiencing homelessness. You can opt out of screening.
Law: Cal. Health & Safety Code 127406; Cal. Health & Safety Code 127400-127446 (esp. 127400, 127405, 127406, 127410, 127440)
- Applying for coverage first
A hospital may not make you apply for Medicare, Medi-Cal or other coverage before it screens you for, or gives you, a discount. It may ask you to take part in a Medi-Cal screening.
- Notice you must get
The hospital must give you a written notice about its charity care and discount policies at the time of service or at discharge (or mail it within 72 hours if you leave without it), in English and other languages, and post it in the emergency room, billing and admissions offices and on its website.
- If you disagree
If you disagree with a decision, you can ask the hospital's business manager, chief financial officer or other manager named in the policy to review it. You can also file a complaint with the Department of Health Care Access and Information (HCAI).
- Refunds
If you paid more than you owed under these rules, the hospital must refund the extra within 30 days, with interest (not required if the amount is under $5).
- Other providers
Emergency room doctors must also offer discounts to uninsured patients and patients with high medical costs at or below 400% of the poverty level.
Law: Cal. Health & Safety Code 127452; Cal. Health & Safety Code 127400-127446 (esp. 127400, 127405, 127406, 127410, 127440)
- 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.
Free tools, letters and checklist
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.
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.
Who counts as family for charity care in California?
Your family means your spouse or domestic partner and dependent children under 21 (or any age if disabled); for a minor, the parents or caretaker relatives and their dependent children.