Medical bills in Texas: free care, credit reports and your rights

Texas has a state charity-care law, but it does not set one income limit: each hospital's policy decides who gets free or discounted care.

Texas law limits when some medical debt can be reported to credit bureaus.

Charity care means free or discounted care for people with low income. Hospitals also call it financial assistance.

Can I get my bill reduced?Is my debt too old?Can they sue me or report it?Free help

Checked against official sources: October 30, 2026.

Federal rules for nonprofit hospitals apply in every state. Free help can review your bill.

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Can I get my bill reduced in Texas?

Texas has a state charity-care law, but it does not set one income limit: each hospital's policy decides who gets free or discounted care.

The law

Nonprofit hospital community benefits and charity care law

Law: Texas Health and Safety Code chapter 311, subchapter D; Tex. Health & Safety Code 311.031(7), (11), (13); Tex. Health & Safety Code 311.042; Tex. Health & Safety Code 311.043; Tex. Health & Safety Code 311.045; Tex. Health & Safety Code 311.046(d); Tex. Health & Safety Code 324.101(a), (c), (i); Tex. Health & Safety Code 324.102

Which hospitals

Nonprofit hospitals and nonprofit hospital systems (hospitals that are tax-exempt or eligible for tax-exempt bonds and organized as a nonprofit or charitable trust).

Who can get help

People the hospital classifies as "financially indigent" (uninsured or underinsured people accepted for free or discounted care under the hospital's eligibility system) or "medically indigent" (your hospital or medical bills left after insurance are more than a share of your yearly income set by the hospital, and you can't pay them).

Deadline to apply

No state deadline. A hospital may decide that you are financially or medically indigent after you get care.

Law: Tex. Health & Safety Code 311.031(7), (11), (13); Tex. Health & Safety Code 311.042; Tex. Health & Safety Code 311.043; Tex. Health & Safety Code 311.045; Tex. Health & Safety Code 311.046(d); Tex. Health & Safety Code 324.101(a), (c), (i); Tex. Health & Safety Code 324.102

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Is my debt too old in Texas?

Kind of agreementTime limit to sue
Written contract4 years
Open account4 years

A lawsuit on a debt must be filed within 4 years after the claim accrues. A lawsuit on an open or stated account must also be filed within 4 years. If no other period applies, the time limit is 4 years.

What can restart the clock

A statement acknowledging an old debt can be used to get around the time limit only if it is in writing and signed by you. A debt buyer (a company that bought the debt) may not sue or start arbitration after the 4-year limit, and a payment, a promise to pay or any other activity on the debt does not revive its right to sue.

When the clock starts

For an open or stated account, the time starts on the day the dealings between you and the creditor end.

Law: Tex. Civ. Prac. & Rem. Code 16.004(a)(3), (c); Tex. Civ. Prac. & Rem. Code 16.051; Tex. Civ. Prac. & Rem. Code 16.065; Tex. Fin. Code 392.307(c), (d)

A time limit to sue can differ by kind of agreement, and when it starts and what restarts it can differ; a court decides.

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Can they sue me or report it in Texas?

Credit reports

Partial limit

A credit bureau may not include a medical collection account in your credit report if you had health coverage when you got care and the bill is the balance (after copays, deductibles and coinsurance) owed to an emergency care provider or a facility-based provider for an out-of-network claim.

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Waiting rules

A health care provider, including a hospital, may not pursue debt collection against you until it has sent you a written itemized bill that meets state rules. A provider must bill you by the first day of the 11th month after the date of service (if it bills your health plan directly, it must bill the plan by that date or the date in its contract). If it bills late, it cannot collect from you amounts your health plan would have paid or that you would not have owed if it had billed on time. A hospital, surgery center, birthing center or freestanding emergency room that violates the state billing-policy law may not take or help take third-party collection action, report you to a credit bureau or sue you.

Interest

If you never agreed to pay interest, a creditor may charge legal interest of 6% a year, starting on the 30th day after the amount is due. A hospital or other covered facility's billing policy must say whether it charges interest on amounts not covered by insurance, and at what rate.

Liens on your home

The Texas Constitution protects your homestead from forced sale for the payment of most debts, including medical bills. A hospital may have a lien on your claim or lawsuit against someone who caused an accident that injured you (not on your home), if you were admitted within 72 hours after the accident.

Wage garnishment

Current wages cannot be garnished for medical bills. The Texas Constitution allows garnishment of current wages only for court-ordered child support and spousal maintenance (federal debts such as taxes follow federal law).

Law: Tex. Health & Safety Code 185.002(e), 324.101(a)(4), (g); Tex. Civ. Prac. & Rem. Code 146.002, 146.003; Tex. Fin. Code 302.002; Tex. Const. art. XVI, secs. 28, 50; Tex. Prop. Code 55.002

Surprise bills and ambulance bills in Texas

State law

Texas balance billing law and ground ambulance law

Law: S.B. 1264, 2019; S.B. 2476, 2023; Tex. Ins. Code 1301.155, 1301.164, 1301.165, 1301.166, 1271.159; ch. 1467

Which plans it covers

Health plans regulated by Texas: HMO plans and PPO/EPO plans regulated by the Texas Department of Insurance (the insurance card shows "DOI" or "TDI"), Employees Retirement System of Texas plans (such as HealthSelect), TRS-ActiveCare and TRS-Care Standard, Texas Farm Bureau plans, and employer plans that opted in (the card may show "TXI").

What it adds

For out-of-network emergency care, out-of-network doctors and other facility-based providers at an in-network hospital or other facility, and out-of-network lab and imaging services, you owe only your in-network copay, coinsurance and deductible.

Ground ambulance

The state protects you

If you have a state-regulated plan, an out-of-network ground ambulance (not an air ambulance) may bill you only your copay, coinsurance and deductible. Your plan pays the ambulance the rate set by the local government where the service started or, if none was filed, the lesser of the billed charge or 325% of Medicare.

Law: Tex. Ins. Code 1271.159, 1301.166

Law: Tex. Ins. Code 1301.155, 1301.164, 1301.165, 1301.166, 1271.159; ch. 1467

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Itemized bills and price estimates in Texas

Texas law gives you a right to an itemized bill within 30 days.

When a health care provider (including a hospital, but not a federally qualified health center) asks you to pay, it must send a written itemized bill with a plain-language description of each service and supply, any billing codes sent to your insurer, what the insurer was billed and paid, and what you owe for each item. It must send the bill no later than 30 days after it gets final payment from your insurer. It may send it through a patient portal only if you have an active portal account; otherwise it must mail, email or hand you a copy as you choose. You can ask for another copy later. The provider may not pursue debt collection until it complies. Separately, a hospital, surgery center, birthing center or freestanding emergency room must give you an itemized statement if you ask within 1 year after discharge, within 10 business days of your request.

Law: Tex. Health & Safety Code 185.001, 185.002; Tex. Health & Safety Code 324.101(e)

Price estimates

Before an elective hospital stay or a non-emergency outpatient surgery or other service is scheduled, a hospital, surgery center, birthing center or freestanding emergency room must give you an estimate of its billed charges if you ask. It must email the estimate within 5 business days and tell you how to dispute final charges that are $400 or more above the estimate. Facilities with $10 million or more in yearly revenue must also post their standard charges and a consumer-friendly list of shoppable services.

Law: Tex. Health & Safety Code 324.101(d), (d-1); ch. 327

Health coverage and Medicaid in Texas

Texas Medicaid is Texas's Medicaid program. Apply for it here:

Apply: Texas Medicaid · 2-1-1 or 1-877-541-7905

Where to complain in Texas

Free help in Texas

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Good to know in Texas

  • On August 10, 2026, the U.S. District Court for the Western District of Texas declared that the Texas rule barring credit bureaus from reporting certain out-of-network medical debt is preempted by the federal Fair Credit Reporting Act and barred the state from enforcing it.

    Law: Tex. Bus. & Com. Code 20.05(a)(5)

  • Nonprofit hospitals must provide charity care and government-sponsored indigent care at a level that meets one of the state's standards, such as at least 4% of net patient revenue as part of 5% in total community benefits, and must report each year.

    Law: Tex. Health & Safety Code 311.045

  • The state publishes a yearly manual listing each nonprofit hospital with a summary of its charity care policy.

    Law: Tex. Health & Safety Code 311.0461

Changes in 2024–2026

September 1, 2025: H.B. 216 (2025) changed how providers may send the itemized bill required before collection (patient portal only if you have an active account) and repealed older hospital itemized-statement rules; H.B. 1314 (2025) amended the facility estimate rules; H.B. 4145 (2025) let providers send the timely bill to a patient's attorney in injury cases; S.B. 916 (2025) extended the ground ambulance protection to September 1, 2027. August 10, 2026: a federal court declared the credit bureau ban in Tex. Bus. & Com. Code 20.05(a)(5) preempted (CDIA v. Texas).

Questions about medical bills in Texas

Does Texas require hospitals to give free or discounted care?

Texas has a state charity-care law, but it does not set one income limit: each hospital's policy decides who gets free or discounted care.

Can medical debt be reported to credit bureaus in Texas?

Texas law limits when some medical debt can be reported to credit bureaus. A credit bureau may not include a medical collection account in your credit report if you had health coverage when you got care and the bill is the balance (after copays, deductibles and coinsurance) owed to an emergency care provider or a facility-based provider for an out-of-network claim.

How long can a medical bill be collected or sued on in Texas?

A lawsuit on a debt must be filed within 4 years after the claim accrues. A lawsuit on an open or stated account must also be filed within 4 years.

Can a medical debt lead to wage garnishment or a lien on my home in Texas?

Current wages cannot be garnished for medical bills. The Texas Constitution allows garnishment of current wages only for court-ordered child support and spousal maintenance (federal debts such as taxes follow federal law).

Am I protected from ground ambulance bills in Texas?

If you have a state-regulated plan, an out-of-network ground ambulance (not an air ambulance) may bill you only your copay, coinsurance and deductible. Your plan pays the ambulance the rate set by the local government where the service started or, if none was filed, the lesser of the billed charge or 325% of Medicare.

Do I have a right to an itemized bill in Texas?

When a health care provider (including a hospital, but not a federally qualified health center) asks you to pay, it must send a written itemized bill with a plain-language description of each service and supply, any billing codes sent to your insurer, what the insurer was billed and paid, and what you owe for each item. It must send the bill no later than 30 days after it gets final payment from your insurer.

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Sources

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