Most Florida hospitals will erase a hospital bill entirely if your household income is at or below 200% of the federal poverty level, which in 2026 is $31,920 for one person and $66,000 for a family of four. Several large Florida systems go higher: Baptist Health South Florida writes off bills at or below 300% FPL, and AdventHealth and BayCare do it at 250% FPL. You generally have at least 240 days from your first billing statement to apply, and the discount applies to bills you already received, bills in collections, and in many cases bills you already started paying.
This matters more in Florida than almost anywhere else. Florida has not expanded Medicaid, so adults without children or a qualifying disability have no Medicaid pathway no matter how little they earn. More than 440,000 Floridians left the ACA marketplace in 2026 after the enhanced premium tax credits expired on December 31, 2025. Charity care is the safety net underneath both of those gaps, and hospitals are not required to tell you it exists in a way you will actually notice.
What Charity Care Is in Florida
Charity care, also called a hospital financial assistance program or FAP, is free or discounted medically necessary care that a hospital provides to patients who cannot afford to pay. It is not a loan, not a payment plan, and not something you repay later.
Florida has no state law requiring hospitals to provide charity care at a specific income level. The rules come from two places:
Section 501(r) of the Internal Revenue Code applies to every nonprofit hospital in Florida, which is most of them. Nonprofit hospitals must have a written financial assistance policy, post it and the application form on their website, offer plain-language summaries in the emergency room and admissions areas, limit what they charge approved patients to the "amounts generally billed" to insured patients, and make reasonable efforts to determine FAP eligibility before sending a bill to collections or reporting it to a credit agency. Section 501(r) does not set a minimum income threshold. Each hospital picks its own.
Each hospital's own policy sets the actual income cutoffs, the residency rules, the asset tests if any, and the sliding scale. This is why the same $18,000 emergency room bill can be fully forgiven at one Florida hospital and discounted 60% at the hospital ten miles away.
For-profit hospital chains, including HCA Florida, are not bound by Section 501(r), but most publish financial assistance policies anyway.
2026 Federal Poverty Level: The Numbers Hospitals Use
Every Florida charity care policy is written as a percentage of the federal poverty level. HHS published the 2026 guidelines on January 13, 2026.
| Household size | 100% FPL | 200% FPL | 250% FPL | 300% FPL | 400% FPL |
|---|
| 1 | $15,960 | $31,920 | $39,900 | $47,880 | $63,840 |
| 2 | $21,640 | $43,280 | $54,100 | $64,920 | $86,560 |
| 3 | $27,320 | $54,640 | $68,300 | $81,960 | $109,280 |
| 4 | $33,000 | $66,000 | $82,500 | $99,000 | $132,000 |
| 5 | $38,680 | $77,360 | $96,700 | $116,040 | $154,720 |
| 6 | $44,360 | $88,720 | $110,900 | $133,080 | $177,440 |
| 7 | $50,040 | $100,080 | $125,100 | $150,120 | $200,160 |
| 8 | $55,720 | $111,440 | $139,300 | $167,160 | $222,880 |
Add $5,680 per person for households larger than eight.
Charity Care Thresholds at Major Florida Hospital Systems
These are the published thresholds as of mid-2026. Policies change, sometimes mid-year, so confirm the current version before assuming you do not qualify.
| Hospital system | Free care (100% written off) | Partial discount |
|---|
| Baptist Health South Florida | At or below 300% FPL | Up to 400% FPL |
| AdventHealth | At or below 250% FPL | 251% to 400% FPL |
| BayCare | At or below 250% FPL | Case by case above |
| Orlando Health | At or below 200% FPL | Sliding scale above |
| Tampa General Hospital | At or below 200% FPL | Sliding scale above |
| Lee Health | At or below 200% FPL | 200% to 400% FPL, patient pays about 20% |
| Jackson Health System (Miami-Dade residents) | At or below 200% FPL | 201% to 300% FPL |
| UF Health | At or below approximately 185% FPL | Up to approximately 300% FPL |
| HCA Florida | Uninsured discount plus policy-based assistance | 201% to 400% FPL on balances over $1,500 |
Two things to notice. First, the difference between a 200% policy and a 300% policy is enormous for a family of four: $66,000 versus $99,000 in annual income. Second, Jackson Health System requires Miami-Dade County residency for its full charity care program, which is typical of public hospital districts in Florida.
How to Apply: Step by Step
1. Ask for the financial assistance application by name. Call the number on your bill and say "I am applying for financial assistance under your 501(r) financial assistance policy." Do not say "I cannot afford this," which usually routes you to a payment plan instead. Nonprofit hospitals must give you the application for free.
2. Download the policy and the plain-language summary. Search the hospital's website for "financial assistance policy." Read the income threshold, the residency requirement, whether assets are counted, and whether physician bills are included. This tells you what to expect before you spend time on paperwork.
3. Request an itemized bill first. Ask for the full itemized statement, not the summary. Duplicate charges and services never delivered are common. Correcting the bill before applying means the discount is calculated on a smaller, accurate number.
4. Gather your documents. Most Florida hospitals ask for the same package:
- Government-issued photo ID for the patient and the responsible party
- Proof of income for everyone in the household: the last two to three months of pay stubs, the most recent federal tax return, a Social Security or SSDI award letter, unemployment statements, or a signed statement of no income
- Proof of household size: a tax return listing dependents, birth certificates, or a lease
- Proof of Florida residency and, for county programs, proof of county residency
- Recent bank statements if the hospital applies an asset test
- Denial letters from Medicaid, if you already applied and were denied
5. Apply for Medicaid at the same time. Many Florida hospitals require you to apply for Medicaid and be denied before they will approve charity care. Apply through MyACCESS or by calling 1-866-762-2237. Florida Medicaid can pay retroactively for bills incurred up to three months before your application date if you were eligible during those months, which can wipe out the bill without any charity care involved. Federal law is scheduled to narrow that retroactive window starting in 2027, so do not delay.
6. Submit the application and get proof. Submit in writing, keep a copy of everything, and get the name of the person who received it plus a date. Email or certified mail beats a phone call you cannot document.
7. Tell collections in writing that an application is pending. Under Section 501(r), a nonprofit hospital must suspend extraordinary collection actions, including credit reporting, wage garnishment, and lawsuits, while it processes your application, even an incomplete one. Send a short written notice to the hospital and to any collection agency handling the account.
8. Follow up every two weeks. Processing typically takes 30 to 60 days. Applications get lost. A short call with the date you submitted and the name of who took it moves things faster than waiting.
Deadlines: You Have Longer Than You Think
Under federal rules, nonprofit hospitals must accept and process financial assistance applications for at least 240 days from the date of your first post-discharge billing statement. That is roughly eight months. Many Florida hospitals accept applications later than that, and some accept them at any time.
The 240-day clock matters even if your bill is already at a collection agency. The account being in collections does not close the application window, and the hospital must suspend collection activity once you apply.
If you already made payments on a bill that later gets approved for charity care, ask about a refund. Several Florida systems refund payments made on balances that are subsequently written off. It is rarely automatic, so ask in writing.
What Charity Care Usually Does Not Cover
Approval on the hospital bill does not necessarily cover:
- Physician bills. ER doctors, radiologists, anesthesiologists, and pathologists often bill separately through their own practice groups. Each group has its own financial assistance policy, and you have to apply to each one. Ask the hospital for a list of which physician groups participate in its FAP.
- Ambulance transport. Billed by a private company or a county fire district. Apply to them separately.
- Elective and cosmetic procedures. Most policies cover emergency and medically necessary care only.
- Bills at other facilities. Approval at one hospital in a system does not always transfer to affiliates. Ask which facilities the approval covers.
- Care received out of network on purpose. Some policies exclude non-emergency care you chose to receive at a non-participating facility.
If You Are Denied
A denial is not the end. Work through these in order:
Ask why in writing. The most common reasons are missing documents, income counted incorrectly (gross versus net, a one-time bonus treated as ongoing, a household member counted who does not belong), or a residency mismatch. All three are fixable.
Appeal with corrected documents. Most Florida hospitals accept appeals and reconsiderations. If your income dropped since the pay stubs you submitted, send new ones.
Ask for a hardship exception. Many policies allow a case-by-case exception when medical bills exceed a large share of annual income, even when the income limit is not met. This is often called catastrophic or medical indigence and it is rarely advertised.
Check Florida's Medically Needy program. Florida runs a Medically Needy or share of cost pathway for people whose income is too high for regular Medicaid but who have large medical bills. The medically needy income limit is approximately $180 per month for an individual and $241 for a couple in 2026. Once your incurred medical bills in a month exceed the difference between your income and that limit, Medicaid covers eligible services for the rest of that month. For the aged and disabled pathway there are also asset limits, typically around $5,000 for an individual and $6,000 for a couple. A single large hospital bill can meet a share of cost immediately.
Check county programs. Several Florida counties run their own indigent care programs. The Hillsborough County Health Care Plan covers residents at or below 175% of the federal poverty guidelines who are not eligible for Medicare or Medicaid. Miami-Dade residents can apply through Jackson Health System. Call 211 to find what exists in your county.
Negotiate the balance. If nothing else works, ask for the self-pay or uninsured rate, which is often far below the chargemaster price, and request an interest-free payment plan. Never put a hospital bill on a credit card or a medical credit card before exhausting charity care.
Florida-Specific Context You Should Know
Florida is one of ten states that has not expanded Medicaid. Adults under 65 without dependent children and without a disability determination generally cannot get Florida Medicaid at any income level. Hundreds of thousands of Floridians sit in that coverage gap, earning too much for Medicaid and, if they are under 100% FPL, too little for marketplace subsidies.
Premiums also jumped in 2026. Enhanced ACA subsidies expired at the end of 2025, average marketplace premiums rose sharply, and Florida saw the largest enrollment drop in the country. Roughly 4 million Floridians remain enrolled, but many who dropped coverage are now uninsured and one emergency away from a bill they cannot pay.
Two protections are worth knowing. Under EMTALA, any hospital emergency department must screen and stabilize you regardless of ability to pay, though that does not make the care free. Under the No Surprises Act, if you are uninsured or paying cash, you are entitled to a good faith estimate before scheduled care, and you can dispute a final bill that exceeds the estimate by $400 or more.
More on state programs and income limits: Florida benefits guide.
Frequently Asked Questions
What income qualifies for free hospital care in Florida in 2026?
Most Florida hospitals write off bills entirely at or below 200% of the federal poverty level, which is $31,920 for one person and $66,000 for a family of four in 2026. Baptist Health South Florida goes to 300% FPL, and AdventHealth and BayCare go to 250% FPL. Check the specific hospital's policy, because the thresholds vary widely.
Can I apply for charity care after I already got the bill?
Yes. Nonprofit hospitals must accept financial assistance applications for at least 240 days after your first billing statement, and many accept them longer. You can apply after the bill is overdue and after it has been sent to a collection agency.
Does charity care work if the bill is already in collections?
Yes. Once you submit an application, even an incomplete one, a nonprofit hospital must suspend extraordinary collection actions such as credit reporting, lawsuits, and wage garnishment while it processes your request. Notify both the hospital and the collection agency in writing.
Do I have to be a US citizen to get charity care in Florida?
Hospital charity care policies are set by each hospital and generally do not require citizenship, unlike Medicaid. Some Florida hospitals ask about immigration status on the application. Public hospital programs such as Jackson Health System's charity care do have residency and status requirements. Read the specific policy before assuming you are excluded.
Will charity care cover the emergency room doctor's bill too?
Often not. ER physicians, radiologists, and anesthesiologists usually bill through separate practice groups with their own policies. Ask the hospital for a list of physician groups that participate in its financial assistance policy, and apply separately to the ones that do not.
Can I get a refund on payments I already made?
Sometimes. If your account is approved for charity care after you have made payments, ask in writing whether the hospital refunds payments applied to a balance that was written off. Several Florida systems do, but it is almost never automatic.
What if my income is above the hospital's cutoff?
Ask about a catastrophic or hardship exception, which many policies allow when medical bills consume a large share of annual income. Also check Florida's Medically Needy share of cost pathway, which is based on incurred medical bills rather than income alone, and any county indigent care program where you live.
Do I have to apply for Medicaid first?
Many Florida hospitals require it, and it is worth doing regardless. Florida Medicaid can pay bills retroactively for up to three months before your application date if you were eligible then. Apply at myaccess.myflfamilies.com or call 1-866-762-2237, and keep the denial letter if you are turned down, because hospitals frequently ask for it.
