Charity care in Rhode Island: who gets free or discounted care

Rhode Island has a law that requires hospitals to give free or discounted care to people with income up to 300% 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 Rhode Island

Income (% of poverty level)	What you get	Details
Up to 200%	Free care	If your yearly family income is at or below 200% of the federal poverty level, the hospital must give you full charity care (a 100% discount).
200% to 300%	Discount	If your yearly family income is above 200% and up to 300% of the federal poverty level, the hospital must give you a partial discount on a sliding scale. Each hospital sets the size of the discount.

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

The law

Rhode Island charity care requirements and Department of Health charity care standards

Law: R.I. Gen. Laws 23-17-43; 216-RICR-40-10-23, sec. 23.14; 216-RICR-40-10-23, secs. 23.3 and 23.14 (Rhode Island Department of Health); 216-RICR-40-10-4, sec. 4.5.2

Which hospitals

Every licensed hospital in Rhode Island, as a condition of its license.

Who can get help

Uninsured, low-income Rhode Island residents (whatever their citizenship or immigration status) who are not eligible for state, federal or employer-sponsored health insurance. The rules cover essential inpatient and outpatient medical services the hospital routinely bills and that Rhode Island Medicaid routinely pays for.

Savings and other assets

Allowed. A hospital may also require that your assets be no more than an asset limit ($8,000 for a single person and $12,000 for a family in 2006, raised each year by the Consumer Price Index). If your income qualifies you for full charity care but your assets are over the limit, the hospital must still give you its highest partial discount, and the most it may try to collect is your assets minus the asset limit.

Who counts as your family

Income is counted by family unit size.

Law: 216-RICR-40-10-23, secs. 23.3 and 23.14 (Rhode Island Department of Health); 216-RICR-40-10-4, sec. 4.5.2; R.I. Gen. Laws 23-17-43

How to apply in Rhode Island

Applying for coverage first: The standards apply to people who are not eligible for state, federal or employer coverage, and the hospital may deny charity care if you do not give information about other available financial resources.
Notice you must get: The hospital must post the state-approved Notice of Hospital Financial-Aid (at least letter size) in emergency departments, admission areas and outpatient areas and on its website, put the same notice on every patient bill, and offer it in other languages. Its Financial-Aid Criteria, including the sliding-scale discount schedule, must be available to anyone who asks.
If you disagree: The hospital must decide within 14 days after receiving your completed application and tell you in writing. It must have a written appeals process for denials and give it to anyone who asks.

Law: 216-RICR-40-10-23, secs. 23.3 and 23.14 (Rhode Island Department of Health); 216-RICR-40-10-4, sec. 4.5.2; R.I. Gen. Laws 23-17-43

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 Rhode Island law.

Free tools, letters and checklist

Where to complain in Rhode Island

Hospital licensing: Rhode Island Department of Health
A hospital did not follow the charity care standards (income levels, notices, 14-day decision, appeals).
Health plan problems: Office of the Health Insurance Commissioner (OHIC)
Problems with a state-regulated health insurance plan.
Debt collectors: Rhode Island Department of Business Regulation, Division of Banking
A licensed debt collector broke state rules.
Attorney general: Rhode Island Attorney General, Consumer Protection Unit
A credit bureau or collector did not fix a medical-debt violation within 30 days after you told it.

Questions about medical bills in Rhode Island

Does Rhode Island require hospitals to give free or discounted care?

Rhode Island has a law that requires hospitals to give free or discounted care to people with income up to 300% of the federal poverty level.

Who counts as family for charity care in Rhode Island?

Income is counted by family unit size.

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