Tax-exempt hospital organizations subject to Internal Revenue Code section 501(r) must maintain written Financial Assistance Policies (FAPs) that describe eligibility, assistance, how to apply and other required information for emergency and medically necessary care.
This is a separate layer from a manufacturer copay card, free-drug program or independent disease foundation. A patient can have a medicine-assistance question and a hospital-billing assistance question at the same time.
- Is the treatment at a tax-exempt hospital facility?
- Current FAP and plain-language summary
- Income/household eligibility criteria
- Application and required documents
- Which billed providers are covered by the FAP
- Whether the account can be held during review
- Separate manufacturer/foundation assistance for the medicine
Ask for the actual FAP and application
The IRS requires qualifying hospital facilities to widely publicize their FAP, application and plain-language summary. Look for the hospital’s financial-assistance or charity-care page, or ask the billing/financial-counseling office for it.
Eligibility is hospital-specific. Do not assume a national income cutoff or that every provider billing at the hospital is covered by the same FAP.
Check what services and providers the policy covers
A hospital FAP must address emergency and other medically necessary care provided by the hospital and certain related entities, and it must identify which other providers in the hospital are or are not covered by the policy.
For an infusion, that distinction can matter if the hospital, physician group, lab and specialty pharmacy bill separately.
Apply before the bill becomes a collections problem
The FAP should explain how to apply and what documentation is required. Section 501(r) also includes billing-and-collection protections that require reasonable efforts to determine FAP eligibility before certain extraordinary collection actions.
If the patient already received a bill, ask whether the account can be held while a complete assistance application is being reviewed.
Use the source that actually controls your case
MedicineCostHelp can organize the problem, but the member-specific plan, Medicare program, provider billing record or assistance program makes the actual decision. Save written determinations and reference numbers so the next person does not have to reconstruct the case from scratch.