We are all aware that there are for profit hospitals and not for profit hospitals. Most hospitals in the US are non-profit hospitals. This means they have agreed with the IRS to be a non-profit. This means they are not allowed to make profits like a business would. In the past, Hospitals used to charge the Insurance companies lower medical rates than they did the general public. This resulted in the public paying much higher medical bills than did insurance companies. It also made charging the individual, and not the insurance more profitable because the individual paid a higher rate.
On January 1, 2015 a new federal statute came into effect. It is known as 501 C 3 (r) which says individuals must be charged the same rate or less than the insurance industry. That to charge people more then insurance is engaging in profit making. So the most an individual can be charged is no more than the hospitals HMO would be charged.
The other part of this same law stated also that some people, based on family income, will owe nothing or will owe a reduced amount lower than insurance would pay.
Enter what is known as the federal poverty level which applies to people with family incomes up to $80,000 a year. The big question people ask is where do they fall on this Federal Poverty level? The following chart is where you can learn this information:
In the above chart, find the family size residing under your roof then go across and find what the amount was on Last years Federal Tax form on line 37. Then look at the top of that column and that is where your family falls in the Federal poverty level. As the new statute states, anyone under 400% of the poverty level is entitled to a discounted rate lower than what it would charge the HMO. If you are under 100% of the poverty level, you owe nothing if you have no large assets. Each Hospital is required to post there policy on there web site. You will usually find it putting the hospitals name and the words charity care in google. May hospitals write off the entire bill if you are under 200% of the poverty level so checking the hospital policy is worth looking into. The billing department does not handle this but the department usually goes by the name charity care write offs. One of our members who was under 200% of the poverty level and owned a $100,000 homes and I had the California hospital write off a $47,000 hospital bill. Because of employees in that hospital knew nothing of this law, I had to contact the Chief Financial Officer for that hospital who immediately said they would write it off.
If this is all too complicated for you and you encounter a large bill, you can make a copy of the following story by the American Bar association and give it to an attorney, The attorney can handle it from there. Exercise your rights under the law.
Crafting a Compliant Financial Assistance Policy under the Final 501(r) Regulations
Medical bill Assistance
International Autoimmune Encephalitis Society, Inc. IAE Society is a Delaware Charitable foundation and a registered 501(c)(3) organization.
International Autoimmune Encephalitis Society
Empowering victims of Autoimmune Encephalitis and caregivers through Support and Education
You can make up to $80,000 a year in some cases and still qualify for the Charity care program.