Sierra Freeman’s heart-related medical emergency in 2022 quickly ballooned into a more than $4 million financial emergency after a brain bleed kept her in the hospital for two months.
That “was certainly stressful,” Freeman said. “I was still recuperating and getting back to work and also had this $4 million bill looming in the background. Definitely not great for a condition that’s worsened by stress.”
Then, her mom found Dollar For, a free nonprofit that helps patients navigate and apply for hospital charity care programs. Charity care is free or discounted medically necessary inpatient and emergency services from hospitals to patients who can’t afford their medical bills. Patients usually must meet specific household income and financial hardship criteria. Freeman said she applied twice for financial aid from Stanford Health Care, the hospital where she was flown to receive specialized medical care, but was denied.
“We both thought it was a scam, initially,” Freeman said of Dollar For. But “I figured that the worst that could happen with Dollar For is that they applied on my behalf and I got denied a third time. The other options I was finding online were things like creating a GoFundMe or declaring bankruptcy, so it was one of my better options. I had gotten nowhere with Stanford. But the second Dollar For came in, they were like, ‘OK, now we’re listening.'”
Freeman’s health insurance company ended up covering the bulk of her bills, but Dollar For managed to get her charity care that cut her portion down to hundreds of dollars, from tens of thousands. Hers is one of 50,000 financial assistance applications Dollar For has submitted to save Americans more than $151 million in medical debt.
“Medical debt is the #1 reason people file for bankruptcy, but they don’t have to,” said Jared Walker, Dollar For founder. “They’re filing bankruptcy or getting on payment plans for bills they don’t have to pay.”
How Does Charity Care Work?
Charity care is free or discounted healthcare for patients who meet the organization’s eligibility criteria for financial assistance and can’t pay for all or a portion of services, according to the IRS.
Hospitals decide their own eligibility criteria and whether they will provide it to both uninsured and insured patients, nonprofit healthcare researcher KFF said. Federal law requires nonprofit hospitals — which account for nearly three-fifths (58%) of community hospitals — to provide some level of charity care to receive tax-exempt status, and many state governments require all or a subset of hospitals to extend eligibility for charity care to certain groups of patients, KFF said.
To receive charity care, patients usually must apply at the hospital where they received care. Each hospital has its own rules — how to apply, who’s eligible and how much charity care is provided, analysts said. Hospitals typically consider the patient’s income, the number of people in the household, and the bill’s age when deciding who qualifies.
Still, patients often don’t apply because they don’t know about it, Walker said.
“The law only says a hospital has to have a financial assistance policy that has to be widely publicized and available. So, they put a poster up in the ER and it’s widely publicized. They put it on a page on their website and it’s widely available,” Walker said. “But it’s really a best-kept secret.”
How Can Patients Access Charity Care?
Informed patients can ask hospitals for financial assistance. But even if you’re lucky enough to learn about the hospital’s charity care, most will find the process difficult, even down to submitting the application, Walker said.
“Hospitals will still want you to fax or mail in applications,” Walker said.
Since Dollar For focuses on finding Americans relief from medical bills, it has built databases of most hospitals nationwide with all their policies and requirements, and knows how to negotiate medical debt, Walker said.
“Our process is easier than any hospital in the nation,” he said. “If you know what’s your household income and size and what hospital you were in, you can know within seconds if you’re eligible for charity care.”
If you are, Dollar For will “submit the paperwork, and hopefully wipe out those medical bills. They don’t pay your bills; they get the hospital to forgive them. And their services are entirely free,” said Triage Cancer on its website. Triage Care, a national nonprofit providing free education on the legal and practical issues that may impact cancer patients and their caregivers, is one of many partners that send patients to Dollar For for help.
“The first thing people should do if they get a giant bill when they go home is think of charity care,” Walker said. “Why care about a bill you don’t have to pay? You can almost always negotiate medical bills. We even have scripts and resources on Dollar For to help. The line everyone needs to remember is, ‘What is the settlement amount?'”
There’s always a number hospitals will take in one lump sum that day to close out the account, he said. Just that can consistently get you 30% to 40% off your bill, Walker said.
Medora Lee is a money, markets, and personal finance reporter at USA TODAY. You can reach her at [email protected] and subscribe to our free Daily Money newsletter for personal finance tips and business news every Monday through Friday.
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