Charity care in Maine: who gets free or discounted care

Maine has a law that requires hospitals to give free or discounted care to people with income up to 200% 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 Maine

Income (% of poverty level)	What you get	Details
Up to 200%	Free care	If your family income is at or below 200% of the federal poverty level, the hospital must give you free medically necessary care (charity care). Income is counted either as 4 times your last 3 months of income or as your actual income for the last 12 months.

These are the income levels written in the law. Each hospital decides using its own policy.

The law

Charity care and financial assistance programs provided by hospitals

Law: 22 M.R.S. § 1716-A; 22 M.R.S. §§ 1715, 1716-A

Which hospitals

Hospitals in Maine, nonprofit or for-profit. Certain outpatient providers that offer imaging, lab, cardiac diagnostic, lithotripsy or ambulatory surgery services (including hospital-affiliated providers) must also give charity care under a policy consistent with the hospital rules.

Who can get help

Maine residents (people living in Maine who intend to stay, or who came to Maine for a job or to look for work; not tourists or visitors). The law sets the free care line by family income.

Savings and other assets

Not allowed for charity care. A hospital may not ask about assets or income that are not counted in modified adjusted gross income (the Medicaid income method).

Who counts as your family

Family means 2 or more people related by birth, marriage or adoption who live together and have legal duties to support each other. Income of others in the household who are not family does not count.

Law: 22 M.R.S. §§ 1715, 1716-A

How to apply in Maine

Deadline to apply

Maine law does not set an application deadline. Within 15 days after getting your application, the hospital must tell you what is missing and then give you at least 30 days to send it before denying for incompleteness. It must decide within 45 days after you send a complete application.

Screening for help

When you are admitted (or before discharge after an emergency admission), the hospital must check whether you have insurance or state or federal medical assistance.

Law: 22 M.R.S. § 1716-A(2); 22 M.R.S. §§ 1715, 1716-A

Notice you must get

Hospitals must give you written notice of charity care when you are admitted as an inpatient (or before discharge after an emergency admission), and with your bill or at the time of an outpatient service. The notice must include the income limits, a phone number and website for the application, and information about free help from the Health Insurance Consumer Assistance Program. Every bill must say how to apply for financial assistance and how to dispute a charge. Hospitals must post a plain-language summary and the application on their website and in admission and waiting areas, translate the charity care application and summary into languages spoken by 5% or 1,000 people in Maine or in the hospital's community (whichever is less), and provide interpreters. By July 1, 2028, hospitals must offer an online application.

If you disagree

If you are denied charity care, the hospital must give you a written, dated statement of the reasons and tell you about your right to ask the Department of Health and Human Services for a fair hearing. You can also complain to the Department, which must review a complaint within 30 days and can order the hospital to fix the problem and adjust your bill.

Other providers

Outpatient providers of imaging, laboratory, cardiac diagnostic, lithotripsy and Medicare-certified ambulatory surgery services, and other outpatient services using equipment costing $500,000 or more, must provide care to people eligible for charity care under a policy consistent with the hospital rules.

Law: 22 M.R.S. § 1715; 22 M.R.S. §§ 1715, 1716-A

Law: 22 M.R.S. §§ 1715, 1716-A

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 Maine law.

Free tools, letters and checklist

Where to complain in Maine

Hospital bills and financial assistance: Maine Department of Health and Human Services, Division of Licensing and Certification
A hospital did not follow the charity care or financial assistance rules, or you want to complain about a licensed hospital or facility.
Health insurance: Maine Bureau of Insurance, Consumer Health Care Division · 1-800-300-5000
Problems with a state-regulated health plan, including surprise bills, emergency or ambulance bills and denials.
Debt collectors: Maine Bureau of Consumer Credit Protection · 1-800-332-8529
A debt collector or debt buyer broke Maine's medical debt collection or credit reporting rules.

Questions about medical bills in Maine

Does Maine require hospitals to give free or discounted care?

Maine has a law that requires hospitals to give free or discounted care to people with income up to 200% of the federal poverty level.

Who counts as family for charity care in Maine?

Nearby states

National rules that apply in every state

Nonprofit hospitals (federal rules)

Each nonprofit hospital must have a written financial assistance policy (FAP).

Law: 26 U.S.C. 501(r)(4); 26 CFR 1.501(r)-4

Before any ECA, the hospital must tell you about financial assistance and wait at least 120 days from the first bill sent after you left the hospital.

Law: 26 CFR 1.501(r)-6(c)(3)

You can apply for at least 240 days from the first bill sent after you left the hospital.

Law: 26 CFR 1.501(r)-1(b)(3)

If you apply during the application period, even with an incomplete application, the hospital and its collectors must stop starting or continuing ECAs until the hospital decides, or until you fail to send requested information within a reasonable time.

Law: 26 CFR 1.501(r)-6(c)(8)

Once you are found eligible, the hospital cannot charge you more than the amounts generally billed (AGB) to people with insurance for emergency or other medically necessary care, and must charge less than its full gross charges for other covered care.

Law: 26 U.S.C. 501(r)(5); 26 CFR 1.501(r)-5

Surprise bills (No Surprises Act)

With most private health plans (job-based plans, Marketplace and other individual plans), you are protected from surprise out-of-network bills for emergency care, for non-emergency care at an in-network hospital, hospital outpatient department or ambulatory surgical center, and for air ambulance services.

Law: 42 U.S.C. 300gg-111, 300gg-131, 300gg-132, 300gg-135

For protected services, you can't be charged more than your in-network cost-sharing (copay, coinsurance, deductible).

Law: 42 U.S.C. 300gg-131, 300gg-132

Ground ambulance services are generally not covered by these federal protections, unless a state law has different rules.

Law: CMS, Know your rights when using insurance

If you don't have insurance or won't use it, providers and facilities must usually give you a written good faith estimate.

Law: 42 U.S.C. 300gg-136; 45 CFR 149.610

If one provider's or facility's bill is at least $400 more than its good faith estimate, you can use the federal patient-provider dispute resolution process.

Law: 45 CFR 149.620(a)(2)(ii), (c)(1)

Credit reports

A collection account generally cannot be reported for more than 7 years.

Law: 15 U.S.C. 1681c(a)(4), (c)(1)

For a veteran's medical debt (care authorized by the VA from a non-VA provider, or a bill the VA charged in error), nationwide credit bureaus may not report it until 1 year after the care, and may not report it once it is fully paid or settled, when they know it is a veteran's medical debt.

Law: 15 U.S.C. 1681c(a)(7), (8); 15 U.S.C. 1681a

If a medical debt on your credit report is wrong, you can dispute it with the credit bureau for free.

Law: 15 U.S.C. 1681i(a)(1)

Debt collectors

A debt collector must give you validation information about the debt, including the amount and how to dispute it.

Law: 12 CFR 1006.34

If you dispute the debt in writing within the validation period, the collector must stop collecting the disputed amount until it sends you verification of the debt.

Law: 12 CFR 1006.38(c), (d)(2)

A debt collector must not sue or threaten to sue you on a time-barred debt, meaning a debt whose statute of limitations has run out.

Law: 12 CFR 1006.26(b)

Itemized bills and price lists

Your medical and billing records kept by a health care provider are part of your 'designated record set'.

Law: 45 CFR 164.501 (designated record set); 45 CFR 164.524(b)(2)

If Medicare paid for an item or service, you can ask the provider in writing for an itemized statement.

Law: 42 U.S.C. 1395b-7(b)

Every hospital must post online a machine-readable file of all its standard charges, and a consumer-friendly list of at least 300 shoppable services (or an online price estimator tool).

Law: 45 CFR 180.40, 180.50, 180.60

Medicaid and Medicare

If you qualify for Medicaid, it can pay for covered care you got up to 3 months before the month you applied, if you were eligible then.

Law: 42 U.S.C. 1396a(a)(34), 1396d(a); Pub. L. 119-21, sec. 71112 (July 4, 2025)

If you are in the Qualified Medicare Beneficiary (QMB) program, Medicare providers may not bill you for Medicare deductibles, coinsurance or copays for Medicare-covered care.

Law: 42 U.S.C. 1396a(n)(3)(B); CMS

If your health plan denies a claim

You must file an internal appeal within 180 days (6 months) of the notice that your claim was denied.

Law: 45 CFR 147.136(b); HealthCare.gov

After a final denial, you can ask for an external review by an independent reviewer within 4 months.

Law: 45 CFR 147.136(c), (d); HealthCare.gov

National help