Charity care in Delaware: who gets free or discounted care
Starting January 1, 2027, Delaware will require hospitals to give free or discounted care to people with income up to 400% of the federal poverty level (the exact level depends on the hospital and your situation).
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 Delaware
| Income (% of poverty level) | What you get | Details |
|---|---|---|
| Up to 300% | Free care | Starting January 1, 2027: if your household income is at or below 300% of the federal poverty level, the hospital must cover all of what you owe for medically necessary hospital services. All covered hospitals and facility-based providers |
| 301% to 350% | Discount | Starting January 1, 2027: if your household income is above 300% and up to 350% of the poverty level, what you owe must be cut by at least 75%. All covered hospitals and facility-based providers |
| 351% to 400% | Discount | Starting January 1, 2027: if your household income is above 350% and up to 400% of the poverty level, what you owe must be cut by at least 50%. All covered hospitals and facility-based providers |
| 401% to 500% | Discount | Starting January 1, 2027: if your income is above 400% and you have a medical hardship (out-of-pocket hospital costs for a visit of 10% or more of yearly household income), the hospital's hardship policy must cut what you owe by at least 50%. A hospital may set an income limit for hardship help, but not below 500% of the poverty level. All covered hospitals, for patients with a medical hardship |
These are the income levels written in the law. Each hospital decides using its own policy.
- The law
Delaware hospital financial assistance law
Law: 16 Del. C. ch. 99, subch. VII, enacted by Senate Substitute 1 for SB 13, 2026; 16 Del. C. 9311(e), 9961-9966 (85 Del. Laws c. 349); 6 Del. C. 2503J, 2505J(f)
- Which hospitals
Starting January 1, 2027: all Delaware licensed hospitals, nonprofit or for-profit, except hospitals that provide only psychiatric, rehabilitation or long-term acute care. Hospital services include care at off-campus sites under the hospital's license and at its freestanding emergency departments, whoever bills for it. Doctors and other licensed professionals who provide hospital services ('facility-based providers') must give the same financial assistance.
- Who can get help
Delaware residents whose household income is at or below the law's levels, whether or not they have insurance. The help covers what you owe yourself (deductibles, copays, coinsurance and other balances) for medically necessary hospital services. Patients above the income levels can get help under the hospital's medical hardship policy if their out-of-pocket hospital costs for a visit equal or exceed 10% of yearly household income.
Law: 16 Del. C. 9311(e), 9961-9966 (85 Del. Laws c. 349); 6 Del. C. 2503J, 2505J(f)
How to apply in Delaware
- Deadline to apply
Once the rest of the new financial assistance law takes effect (when the Diamond State Hospital Cost Review Board adopts final rules, or July 1, 2027, whichever comes first): you may apply at any time during collections, even after the account has been sold or sent to a collector. If you were denied, you may apply again if your finances change or you have more medical bills.
- Screening for help
Hospitals must offer financial assistance screening and an application to every patient who is uninsured, pays any part of the bill themselves, or owes $500 or more after insurance, and must tell each patient orally at registration or admission how to apply. Hospitals must also use presumptive eligibility screening set by the Board; if you are presumed eligible you do not have to fill out a full application. Most of these process rules take effect when the Board adopts final regulations or July 1, 2027, whichever is earlier; the income levels take effect January 1, 2027.
Law: 16 Del. C. 9962(i), 9964; 85 Del. Laws c. 349, sec. 6; 16 Del. C. 9311(e), 9961-9966 (85 Del. Laws c. 349); 6 Del. C. 2503J, 2505J(f)
- Applying for coverage first
Once the rest of the new financial assistance law takes effect (when the Diamond State Hospital Cost Review Board adopts final rules, or July 1, 2027, whichever comes first): a hospital may not deny or delay financial assistance because you might qualify for Medicaid or other public coverage unless it has screened you for that coverage, made reasonable efforts to help you enroll and documented the result. If you are not eligible for Medicaid under the law, you cannot be required to be screened for it. Financial assistance may not be made to depend on paying first, joining a payment plan or using up other options.
- Notice you must get
Today, large health-care facilities must give uninsured emergency, inpatient and surgery patients written information on applying for Medicaid and other medical assistance at the time of service and on each bill. Once the rest of the new financial assistance law takes effect (when the Diamond State Hospital Cost Review Board adopts final rules, or July 1, 2027, whichever comes first): hospitals must post notices in registration, admission and billing areas, give oral notice at registration or admission, and send written notice and an application with each bill to patients who are uninsured, self-pay or owe $500 or more after insurance, in every language spoken by more than 5% of the service area.
- If you disagree
Once the rest of the new financial assistance law takes effect (when the Diamond State Hospital Cost Review Board adopts final rules, or July 1, 2027, whichever comes first): the hospital must decide within 21 days after you turn in a complete application and tell you in writing, including how to appeal a denial. You may add documents to your appeal. While an application or appeal is pending, the hospital must tell you in writing that you are not responsible for the bills, and may not send the account to collections, sell it, report it to a credit bureau or sue.
- Refunds
Today, under the Medical Debt Protection Act, if you paid more than you owe after a large health-care facility's financial assistance, the facility or collector must refund the extra within 60 days. Once the rest of the new financial assistance law takes effect (when the Diamond State Hospital Cost Review Board adopts final rules, or July 1, 2027, whichever comes first): if the hospital failed to screen you for presumptive eligibility or wrongly denied you, it must refund what you paid and waive what you owe that financial assistance covers, including reasonable costs you had to pay to get the assistance.
- Other providers
Starting January 1, 2027, doctors and other licensed professionals who provide hospital services ('facility-based providers') must give the same minimum financial assistance (16 Del. C. 9962(a)). Once the rest of the new financial assistance law takes effect (when the Diamond State Hospital Cost Review Board adopts final rules, or July 1, 2027, whichever comes first): they must accept a hospital's written eligibility notice as proof, and an eligibility notice from one hospital must be honored by other hospitals for the period it covers (16 Del. C. 9962(f), (g)).
Law: 16 Del. C. 9311(e), 9961-9966 (85 Del. Laws c. 349); 6 Del. C. 2503J, 2505J(f)
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 Delaware law.
Free tools, letters and checklist
Where to complain in Delaware
- Attorney general: Delaware Department of Justice, Consumer Protection Unit · (800) 220-5424
A hospital, collector or debt buyer broke the Medical Debt Protection Act (a violation is an unlawful practice under the Consumer Fraud Act), or other unfair collection practices. - Health insurance: Delaware Department of Insurance, Consumer Services Division · 1-800-282-8611
Problems with a Delaware health insurance policy, including emergency balance bills and appeals.
Questions about medical bills in Delaware
Does Delaware require hospitals to give free or discounted care?
Starting January 1, 2027, Delaware will require hospitals to give free or discounted care to people with income up to 400% of the federal poverty level (the exact level depends on the hospital and your situation).