Request for financial assistance (charity care)

Here is a letter asking the hospital for its financial assistance policy and application, with a hold on collections meanwhile. Nonprofit hospitals must have one, so it is well worth asking.

Use it for a hospital bill you may not be able to pay. Nonprofit hospitals must have a financial assistance policy. · Checked 28 September 2026

The letter

This is the draft Med Bill Check writes. On the home page you can add your details and, for a review letter, the code and amount, and it fills them in. Anything in [brackets] is for you to complete.

[Your full name]
[Your address]
[Your phone or email]
[Today's date]

Billing Department
[Provider or hospital name]
[Provider address]

Re: Account number [account number], date of service [date of service], patient [patient name]

Dear Billing Department,

I would like to apply for financial assistance (charity care) for the account above.

Please send me your Financial Assistance Policy, the plain-language summary, and the application form, and tell me what documents you need. Nonprofit hospitals are required to have a written financial assistance policy under federal tax rules.

Please put the account on hold and do not send it to collections while my application is considered.

Thank you for your help. I look forward to hearing from you.

Sincerely,
[Your name]

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Sources

This is a draft for you to review, edit and send yourself. It is general information, not legal, medical or financial advice. Med Bill Check never sends anything for you.

Ask Med Bill Check yourself

Choose the letter, add what you know, and copy the draft to send yourself. Open Med Bill Check, free, no sign-up.

In Claude or any app that takes MCP connectors, add https://goodturn-mcp.pages.dev/medbillcheck/mcp and ask: “How do I apply for charity care at my hospital?”