Medical bills in Maryland: free care, credit reports and your rights
Maryland has a law that requires hospitals to give free or discounted care to people with income up to 300% of the federal poverty level (the exact level depends on the hospital and your situation).
Maryland 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 Maryland?
Maryland has a law that requires hospitals to give free or discounted care to people with income up to 300% of the federal poverty level (the exact level depends on the hospital and your situation).
| 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 medically necessary care for free. All covered hospitals |
| 201% to 250% | Discount | If your family income is from 201% to 250% of the federal poverty level, the hospital must cut what you owe out of pocket by at least 75%. All covered hospitals |
| 251% to 300% | Discount | If your family income is above 250% and up to 300% of the federal poverty level, the hospital must cut what you owe out of pocket by at least 60%. All covered hospitals |
| 301% to 350% | Discount | If you have a financial hardship (medical debt over 12 months that is more than 25% of family income) and your family income is above 300% and up to 350% of the poverty level, the hospital must cut your out-of-pocket costs by at least 50%. All covered hospitals, for patients with a financial hardship |
| 351% to 400% | Discount | With a financial hardship and family income above 350% and up to 400% of the poverty level, the cut is at least 45%. All covered hospitals, for patients with a financial hardship |
| 401% to 450% | Discount | With a financial hardship and family income above 400% and up to 450% of the poverty level, the cut is at least 40%. All covered hospitals, for patients with a financial hardship |
| 451% to 500% | Discount | With a financial hardship and family income above 450% and up to 500% of the poverty level, the cut is at least 35%. All covered hospitals, for patients with a financial hardship |
These are the income levels written in the law. Each hospital decides using its own policy.
- The law
Maryland hospital financial assistance law (free and reduced-cost care), enforced by the Health Services Cost Review Commission (HSCRC)
- Which hospitals
Every acute care hospital and chronic care hospital in Maryland under the jurisdiction of the Health Services Cost Review Commission (HSCRC), not only nonprofit hospitals.
- Who can get help
Patients without health coverage, and patients whose insurance does not pay the full hospital bill. Under HSCRC rules, hospitals must give free and reduced-cost care to all qualified Maryland residents, whatever their citizenship or immigration status and even if they live outside the hospital's service area.
- The most you can be charged
If you qualify for free or reduced-cost care, the hospital may not collect fees or any amount above the charge for the service approved by the HSCRC.
- Deadline to apply
You have up to 240 days after the day you receive the first hospital bill to apply. The hospital must also consider changes in your finances during those 240 days if you tell it before the period ends.
- Find a hospital's policy
Law: Md. Code, Health-General 19-214.1, 19-214.2, 19-214.3; COMAR 10.37.13.06
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 Maryland law.
Is my debt too old in Maryland?
| Kind of agreement | Time limit to sue |
|---|---|
| Written contract | 3 years |
| Open account | 3 years |
| Oral (spoken) agreement | 3 years |
Most civil lawsuits, including on a contract or an account, must be filed within 3 years. Maryland gives 12 years for a contract under seal, but that longer period does not apply to a consumer's contract with a hospital for hospital services. A creditor or collector may not sue on a consumer debt after the time limit has run out.
- What can restart the clock
No. After the time limit runs out, a payment, a written or spoken promise, or any other activity on the debt does not revive or extend it. A separate written payment agreement made before the deadline can have its own time limit.
- When the clock starts
The 3 years run from the date the claim accrues.
Law: Md. Code, Courts & Judicial Proceedings 5-101, 5-102(c)(3), 5-1202
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 Maryland?
- Credit reports
Full ban
A person whose main business is providing medical services, products or devices, or that person's agent or assignee, may not report any part of a medical debt to a credit bureau, and contracts with collectors or debt buyers must forbid it.
- Waiting rules
Wait before a lawsuit: 240 days after the first bill
A hospital may not sue you over a hospital bill for at least 240 days after the first bill, and may not sue at all if you owe $500 or less. After the 240 days, it must send you a written notice of intent to sue at least 45 days before filing, by certified and first-class mail, with a financial assistance application, information about an income-based payment plan and the information sheet. The hospital may not sue you or send the bill to a collector while it knows an insurance appeal or review is pending (or within 60 days after), while it is processing your request to reconsider a financial assistance denial, or within 60 days after finishing that review. It must first decide whether you qualify for financial assistance and make a good-faith effort to offer a payment plan.
- Interest
If you qualify for free or reduced-cost care, the hospital may not charge interest before a court judgment, or any fees. For other patients on a hospital income-based payment plan, interest may not start until 240 days after the first bill and may not be more than 6% a year simple interest, and the hospital may not charge late fees or extra interest for late payments.
- Liens on your home
A hospital may not force the sale or foreclosure of your primary home or ask for a lien on it to collect a hospital bill. For any medical debt, a lien on a home you own and live in may not be created by a contract or because you did not pay under a contract; a court must remove such a lien. A lawsuit asking for money must say whether the debt is medical debt and give your home address.
- Wage garnishment
A hospital may not garnish your wages for a hospital bill if you qualify for free or reduced-cost care. For other debts, Maryland protects the greater of 75% of your take-home wages or 30 times the state minimum hourly wage for each week of the pay period, plus medical insurance deducted from your pay.
- Selling the debt
A hospital may not sell patient debt, except to a government unit, its contractor or a 501(c)(3) nonprofit only to cancel it. That debt must be at least 2 years old and belong to a person at or below 500% of the poverty level or with medical debt over 5% of family income. You owe nothing on a debt sold this way, and the hospital must dismiss any pending lawsuit on it.
- Lawsuit rules
A hospital's lawsuit must include a sworn statement that the 240 days passed, the notice of intent to sue was sent, you got the financial assistance information sheet and notice, the hospital decided whether you qualify for financial assistance and it tried in good faith to offer a payment plan. It must attach the original or certified bill, the most recent bill, a sworn statement of the balance and a copy of the notice. A hospital may not ask a court for a body attachment or arrest warrant against you, and may not claim against a deceased patient's estate if the patient was known to qualify for free care or the estate is worth less than half the debt. A spouse or other adult is not liable for an adult patient's hospital bill unless they signed a separate consent, not in an emergency.
Law: Md. Code, Health-General 19-214.2; Real Property 14-203.1; Courts & Judicial Proceedings 11-402; Commercial Law 15-601.1; COMAR 10.37.13.04, 10.37.13.05
Payment plans and interest in Maryland
- Hospitals must offer a payment plan
- Monthly payment limit: 5% of your monthly income
Maryland hospitals must offer income-based payment plans to all Maryland residents, whatever their insurance, citizenship or immigration status. The hospital must tell you about the plan before discharge, with the bill, on request and in every collection letter. Monthly payments may not be more than 5% of your monthly household income. Plans are interest free if you qualify for free or reduced-cost care; otherwise interest may not start before 240 days after the first bill and is capped at 6% a year simple interest. There are no fees for paying early and no late fees. You count as keeping up with the plan if you make at least 11 scheduled monthly payments in 12 months. A hospital may not sue you until it has a payment plan policy that follows these rules.
Law: Md. Code, Health-General 19-214.2(d); COMAR 10.37.13.05
Surprise bills and ambulance bills in Maryland
- State law
Maryland balance-billing protections (HMO, on-call and hospital-based physician and ambulance assignment-of-benefits laws)
- Which plans it covers
Health insurance, nonprofit health service plans and HMOs regulated by the Maryland Insurance Administration. Self-funded employer plans are generally not covered by state insurance law.
- What it adds
If you are in an HMO, an out-of-network provider is paid by the HMO at rates set by state law. If you have a state-regulated insurance policy and an out-of-network on-call or hospital-based doctor takes an assignment of your benefits, the doctor may bill you only your deductible, copay or coinsurance (and charges for services that are not covered).
- Ground ambulance
The state protects you
If you have a state-regulated plan, your insurer must pay a public, volunteer or county-contracted ambulance service directly (for insurers other than HMOs, when the ambulance gets an assignment of benefits).
Law: Md. Code, Insurance 15-138
Law: Md. Code, Insurance 14-205.2, 14-205.3, 15-138; Health-General 19-710.1
Itemized bills and price estimates in Maryland
Maryland hospitals must give you an information sheet explaining your bill and your rights, with staff who can help you understand the bill. Before suing, a hospital must attach the original or a certified copy of the hospital bill and the most recent bill to its complaint.
Law: Md. Code, Health-General 19-214.1(f), (g), 19-214.2(i)
Price estimates
On request before or during treatment, a hospital must give you a written estimate of the total charges for non-emergency hospital services, procedures and supplies expected to be billed. The hospital's patient bill of rights must say you can ask for an estimate of hospital charges before care. Hospitals must tell outpatients that they may charge a separate facility fee.
Law: Md. Code, Health-General 19-214.1(f)(1)(vi), 19-342(d)(9); COMAR 10.37.13.03, 10.37.13.08
Health coverage and Medicaid in Maryland
Maryland Medicaid (Medical Assistance Program) is Maryland's Medicaid program. Apply for it here:
Apply: Maryland Medicaid (Medical Assistance Program) · 1-855-642-8572
Where to complain in Maryland
- Hospital bills and financial assistance: Health Services Cost Review Commission (HSCRC) · 410-764-2605
A hospital did not follow Maryland's financial assistance, payment plan, billing or debt collection rules. Complaints go by email to hscrc.patient-complaints@maryland.gov. - Attorney general: Maryland Attorney General, Health Education and Advocacy Unit (HEAU) · 410-528-1840 (toll free 1-877-261-8807)
Help with a medical bill dispute, a financial assistance reconsideration request or a surprise bill; it can file a complaint jointly with the HSCRC and mediate. - Health insurance: Maryland Insurance Administration · 1-800-492-6116
Problems with a state-regulated health insurer or HMO, including balance bills and ambulance bills. - Debt collectors: Maryland Office of Financial Regulation · 410-230-6077
A collection agency broke Maryland collection rules.
Free help in Maryland
Free tools, letters and checklist
Good to know in Maryland
- A Maryland hospital may not sue you over a hospital bill of $500 or less.
Law: Md. Code, Health-General 19-214.2(b)(6)
- The HSCRC can fine a hospital up to $50,000 for each knowing violation, and a violation is also an unfair, abusive and deceptive trade practice under the Maryland Consumer Protection Act.
Law: Md. Code, Health-General 19-214.3(d)
- You cannot give up these protections: a waiver in a hospital policy or patient agreement is void.
Law: Md. Code, Health-General 19-214.3(c)
Changes in 2024–2026
2024: HB 328 limited asset tests to household money assets above $100,000, excluding retirement accounts. October 1, 2025: HB 1020 banned medical debt from credit reports; HB 428 barred contract liens on owner-occupied homes for medical debt and requires debt complaints to say if the debt is medical; HB 268 set minimum discount percentages, barred hospital suits for $500 or less, raised the wait before suit to 240 days and excluded hospital contracts from the 12-year specialty limit; HB 765 allowed hospitals to sell old debt to government or nonprofit buyers only to cancel it (this option ends June 30, 2028). Hospitals had to ask credit bureaus to delete earlier reports by November 1, 2025.
Law: ch. 959; ch. 121; ch. 498; ch. 693; ch. 750; COMAR 10.37.13 (HSCRC patient rights and collection rules) took effect December 11, 2025
Questions about medical bills in Maryland
Does Maryland require hospitals to give free or discounted care?
Maryland has a law that requires hospitals to give free or discounted care to people with income up to 300% of the federal poverty level (the exact level depends on the hospital and your situation).
Can medical debt be reported to credit bureaus in Maryland?
Maryland law bans medical debt from credit reports. A person whose main business is providing medical services, products or devices, or that person's agent or assignee, may not report any part of a medical debt to a credit bureau, and contracts with collectors or debt buyers must forbid it.
How long can a medical bill be collected or sued on in Maryland?
Most civil lawsuits, including on a contract or an account, must be filed within 3 years. Maryland gives 12 years for a contract under seal, but that longer period does not apply to a consumer's contract with a hospital for hospital services.
Can a medical debt lead to wage garnishment or a lien on my home in Maryland?
A hospital may not garnish your wages for a hospital bill if you qualify for free or reduced-cost care. For other debts, Maryland protects the greater of 75% of your take-home wages or 30 times the state minimum hourly wage for each week of the pay period, plus medical insurance deducted from your pay.
Am I protected from ground ambulance bills in Maryland?
If you have a state-regulated plan, your insurer must pay a public, volunteer or county-contracted ambulance service directly (for insurers other than HMOs, when the ambulance gets an assignment of benefits). The ambulance service then may not bill you for covered services beyond your copay, deductible or coinsurance, and may not sue you for money the plan owes.
Can I get a payment plan for a hospital bill in Maryland?
Maryland hospitals must offer income-based payment plans to all Maryland residents, whatever their insurance, citizenship or immigration status. The hospital must tell you about the plan before discharge, with the bill, on request and in every collection letter.
More help
Nearby states
Sources
- Md. Code, Health-General 19-214.1 (financial assistance policy)
- Md. Code, Health-General 19-214.2 (hospital debt collection)
- Md. Code, Health-General 19-214.3 (complaints, penalties)
- Md. Code, Health-General 24-2502 and Commercial Law 14-1213 (medical debt credit reporting)
- Md. Code, Real Property 14-203.1 (no liens for medical debt) and Cts. & Jud. Proc. 11-402
- Md. Code, Cts. & Jud. Proc. 5-101, 5-102, 5-1202 (time limits)
- Md. Code, Insurance 15-138 (ambulance), 14-205.2, 14-205.3; Health-General 19-710.1
- COMAR 10.37.13 (HSCRC patient rights; credit, collection and financial assistance)
- 2025 Laws of Maryland ch. 121 (HB 1020), ch. 498 (HB 428), ch. 693 (HB 268)
- HSCRC Consumers and Patient Complaints
- Maryland Attorney General HEAU
- Maryland Insurance Administration: File a complaint