Medical Bill Assistance in 2026: Programs and How to Apply

Short answer

If you have Medicare and need help with medical bills, start with: (1) Medicare Savings Programs (QMB, SLMB, QI) at your state Medicaid office - these pay Part B premiums and, for QMB, all cost-sharing; (2) Extra Help (Low-Income Subsidy) for Part D drug costs at ssa.gov or medicare.gov; (3) your hospital’s Financial Assistance Policy (FAP) - nonprofit hospitals must offer one; (4) disease-specific foundations if you have a qualifying diagnosis; (5) state medical debt relief programs (Illinois, New York, Connecticut, California, Colorado). A patient advocate can help you navigate applications.

Hospital charity care (Financial Assistance Policy)

Every nonprofit hospital in the United States is required by IRS 501® to publish a written Financial Assistance Policy (FAP) that describes who qualifies, how to apply, and what discounts are available. Most for-profit hospitals also offer discretionary financial assistance.

Who typically qualifies. Eligibility varies by hospital, but most FAPs use income thresholds between 200% and 400% of the Federal Poverty Level. A single person earning under about $31,000 will qualify for full or partial charity care at most nonprofit hospitals; a family of four under about $64,000 will typically qualify for at least a partial discount. Some hospitals also consider assets.

How to apply. Call the hospital’s billing office and ask for the financial assistance application (also called “charity care” or “financial hardship”). You will need proof of income (recent pay stubs, Social Security award letter, tax return), household size, and sometimes bank statements. Applications typically take 30 to 60 days to process. If you are approved, the hospital either writes off the balance entirely or reduces it - often by 50 to 100 percent.

The 240-day rule. IRS 501® prohibits nonprofit hospitals from pursuing extraordinary collection actions (sending to collections, lawsuits, credit reporting) for 240 days from the first bill. That gives you time to apply for FAP before collections becomes a factor.

Where to find your hospital’s FAP. Search “[hospital name] financial assistance policy” - the policy must be publicly posted. Kaiser Permanente, Providence, Mayo Clinic, and most major hospital systems have online applications; smaller hospitals may require paper forms.

Medicare Savings Programs: who qualifies and how to apply

Medicare Savings Programs (MSPs) are state-run programs, funded jointly by federal and state Medicaid dollars, that help Medicare-eligible people pay Part B premiums and, at some levels, Part A premiums and cost-sharing. Four programs, four eligibility tiers.

• Qualified Medicare Beneficiary (QMB) - pays your Part A premium (if applicable), Part B premium ($202.90/month in 2026), and all Medicare deductibles, coinsurance, and copayments. Federal 2026 monthly income limit: $1,350 individual / $1,824 couple (100% of FPL plus the $20 general income disregard). Federal asset limit for 2026: $9,950 individual / $14,910 couple.
• Specified Low-Income Medicare Beneficiary (SLMB) - pays the Part B premium only. Federal 2026 monthly income limit: $1,616 / $2,184 (120% FPL). Same 2026 asset limits as QMB: $9,950 / $14,910.
• Qualifying Individual (QI) - pays the Part B premium only, for slightly higher incomes. Federal 2026 monthly income limit: $1,816 / $2,455 (135% FPL). Same 2026 asset limits: $9,950 / $14,910. QI funding is capped by Congress; states process applications first-come, first-served, and you must reapply every year.
• Qualified Disabled Working Individual (QDWI) - pays Part A premium for working disabled people under 65 who lost premium-free Part A.

Important state variations. Massachusetts uses higher income thresholds (up to 225% FPL) and has no asset test since March 2024. Connecticut, Delaware, Louisiana, Maine, and Mississippi have no asset limits. California reinstated its asset test on January 1, 2026, but with much higher thresholds ($130,000 individual / $195,000 couple). Alaska and Hawaii have slightly higher federal income limits. Even if your income appears above the federal limit, apply - many states set higher limits than the federal floor.

The QMB balance-billing protection. If you have QMB, federal law prohibits any Medicare provider from billing you for Medicare cost-sharing. This protection is strong but frequently violated. If a provider bills you for Medicare cost-sharing after you show them your QMB card, contact your state Medicaid office or your State Health Insurance Assistance Program (SHIP).

How to apply. Contact your state Medicaid office. Application takes 30 to 90 days. SLMB and QI benefits can be retroactive up to three months before your application date.

Extra Help (Low-Income Subsidy) for Part D prescription costs

Extra Help - also called the Low-Income Subsidy (LIS) - is the federal program that reduces Medicare Part D prescription drug costs for people with limited income.

What Extra Help pays for. In 2026, Extra Help covers:

• The full Part D monthly premium for people enrolled in a benchmark plan
• The Part D annual deductible ($0 for full Extra Help; the maximum deductible for standard Part D plans in 2026 is $615)
• Reduced prescription copayments: no more than $5.10 for generic drugs and $12.65 for brand-name drugs in 2026
• No coverage gap and no cost after reaching the annual $2,100 out-of-pocket cap

Who qualifies. As of 2024, the Inflation Reduction Act expanded full Extra Help to everyone with income up to 150% of the Federal Poverty Level - a significant expansion from the previous 135% threshold. In 2026, that translates to about $23,940 per year for an individual and $32,460 per year for a couple (approximately $1,995 / $2,705 per month).

Automatic enrollment. If you already qualify for QMB, SLMB, QI, or full Medicaid, you get Extra Help automatically. If not, you must apply.

How to apply. Online at ssa.gov, by phone at 1-800-772-1213, or using form SSA-1020. Applications are typically processed same-day online or within a few weeks by mail. Resource (asset) limits still apply above the income threshold: about $16,590 individual / $33,100 couple in 2026.

Disease-specific foundations

If you have a qualifying diagnosis, disease-specific foundations often provide co-pay assistance, premium help, or grants for out-of-pocket medical costs. Major foundations covering Medicare-eligible patients:

• HealthWell Foundation - grants for out-of-pocket costs across 60+ diseases; opens and closes funding by disease as donations arrive.
• Patient Advocate Foundation - TotalAssist - the March 2026 merger of the Patient Advocate Foundation and the PAN Foundation produced a single unified charitable assistance program. TotalAssist launched July 1, 2026 with more than 130 disease-specific and health equity funds covering copays, premiums, deductibles, and transportation.
• The Assistance Fund (TAF) - help for rare and chronic conditions.
• CancerCare - financial assistance and support for cancer patients.
• Leukemia & Lymphoma Society (LLS) Patient Aid Program - grants for blood cancer patients.
• American Kidney Fund - help with premiums, transportation, and treatment costs.
• LIVESTRONG Foundation - cancer-related financial navigation.

Critical practical note. Foundation funds open and close throughout the year as donations arrive. If a fund for your disease is closed today, check again in a few weeks. Apply as soon as you have a qualifying diagnosis - do not wait until the bills pile up.

Prescription assistance beyond Extra Help

If you do not qualify for Extra Help, or you need help affording drugs not covered by your Part D plan, several options exist:

• Manufacturer Patient Assistance Programs (PAPs) - most major pharmaceutical manufacturers offer free or reduced-cost medications to patients who meet income criteria. Applications are drug-specific; ask your pharmacist or check the manufacturer’s website.
• NeedyMeds (needymeds.org) - searchable database of manufacturer PAPs, disease-specific funds, and coupons.
• RxAssist (rxassist.org) - similar database with prescriber-focused tools.
• GoodRx and equivalent discount programs - coupon-based discounts at the pharmacy counter. Not assistance in the technical sense but can significantly lower cash-price prescriptions. GoodRx and Medicare drug coverage cannot be combined at the same purchase, but you can choose whichever costs less.
• Medicare Prescription Payment Plan (M3P) - introduced in 2025 under the IRA, this program lets you spread Part D out-of-pocket costs into monthly installments across the calendar year instead of paying a large amount upfront. It does not reduce total costs, but it helps with cash flow. Enrollment is annual and automatic renewal was added in 2026.

State-level medical debt relief programs

A growing number of states have created their own medical debt relief programs since 2023. Coverage and eligibility vary widely.

• Illinois Medical Debt Relief Pilot - launched July 2024 (start of Illinois FY25) under Public Act 103-0647, in partnership with the nonprofit Undue Medical Debt. The first wave of debt relief was announced in November 2024 ($72 million for 52,745 residents). As of early 2026 the program had abolished more than $400 million in medical debt, on the way to a $1 billion target.
• New York State Financial Assistance Law - 2023 law requires nonprofit hospitals to accept charity care applications for up to 240 days after service and prohibits certain aggressive collection practices.
• Connecticut Medical Debt Purchase Program - state-purchased debt relief for qualifying residents.
• California AB 1020 (effective 2022, updated 2024) - enhanced hospital financial assistance disclosure and expanded eligibility.
• Colorado Hospital Financial Assistance Act - requires hospitals to screen uninsured and underinsured patients for financial assistance before pursuing collections.
• Arizona - legislation proposed 2024-2025.

Check your state’s official Medicaid or Department of Health website for the most current program details.

Undue Medical Debt and other debt-purchase nonprofits

Undue Medical Debt (formerly RIP Medical Debt until April 2024) is a nonprofit that purchases eligible medical debt in bulk from providers and debt buyers, then forgives it. Since its founding, it has abolished over $15 billion in medical debt for millions of Americans.

Important: you cannot apply directly to Undue Medical Debt. UMD purchases debt in bulk based on donor-defined criteria (usually income below 400% FPL or debt exceeding 5% of annual income). If your debt is purchased and forgiven, you receive a letter notifying you - no action required on your part.

Several states, including Illinois, Connecticut, and North Carolina, have partnered with Undue Medical Debt as the vehicle for state-level debt relief programs.

What about medical bill “forgiveness”?

Search results for “medical bill forgiveness” often oversell what is actually available. Honest breakdown:

• Charity care write-offs. The most common form of “forgiveness.” Apply through your nonprofit hospital’s Financial Assistance Policy. The write-off is legitimate forgiveness, but it requires an application and income verification.
• Debt purchase by donor-nonprofits. Undue Medical Debt and similar organizations forgive debt they purchase - but you cannot apply, and your debt must meet donor criteria.
• Negotiated write-downs. Providers often accept 40 to 60 percent of a large balance as a lump-sum settlement rather than nothing at all. Get any settlement agreement in writing.
• State-partnered programs. Illinois, New York, Connecticut, and others (see above).
• Bankruptcy discharge. Medical debt is dischargeable in Chapter 7 or Chapter 13 bankruptcy, but this is a last resort with significant credit and legal consequences. Consult a bankruptcy attorney.

There is no federal program that forgives medical debt across the board on application. Be skeptical of any advertisement promising blanket “medical bill forgiveness” without an application, income verification, or clear source.

Payment plans and consolidation

If your bill is correct and you do not qualify for charity care, a payment plan may be the right tool.

• Hospital payment plans. Most hospitals accept monthly payments without interest for large balances. Ask specifically for an interest-free plan and get the agreement in writing.
• Prompt-pay discounts. Many hospitals offer 10 to 30 percent off if you pay the full balance in one payment. Ask.
• Lump-sum settlement. For a large bill, offer 40 to 60 percent as a lump sum in exchange for a written release of the remaining balance and a commitment not to send it to collections or report to credit bureaus.

Be cautious of commercial medical debt consolidation loans. Some are legitimate; many charge high interest rates and can trap you in longer-term debt than the original bill.

For more on when to dispute a bill instead of negotiating, see Baba’s guide to disputing a medical bill.

For what happens if a bill escalates to collections and how the current federal medical debt credit reporting rules work, see Baba’s medical bills in collections guide.

How a Baba advocate helps

Financial assistance applications are onerous. A single hospital FAP application may need a Social Security award letter, three months of pay stubs or bank statements, a tax return, proof of household size, and utility bills. MSP and Extra Help applications require similar documentation and go to different agencies (state Medicaid, Social Security). Coordinating across all of these while you or a family member is unwell is genuinely hard.

A Baba advocate handles this work as part of routine care navigation and advocacy. Talk to Baba to learn what support may be available. What that looks like:

• Eligibility screening across programs. Your advocate reviews your income, assets, diagnosis, and location to identify every program you likely qualify for.
• Application assembly. Your advocate helps assemble the documentation each program requires and completes the forms with you.
• Coordination with providers and agencies. Your advocate handles calls to the hospital billing office, state Medicaid office, Social Security, and disease-specific foundations.
• Follow-up and appeals. If an application is denied or delayed, your advocate follows up, escalates, or files an appeal.