How to get help with hospital bills in Texas
Hospitals across Texas have formal ways to cut or forgive medical bills for patients who cannot pay (or even give free medical care). There are also federal and local regulations in TX that will help lower income patients and find more information below on various programs that help people pay hospital costs.
Non-profits hospitals in Texas
When it comes to a non-profit in Texas, federal rules require every nonprofit hospital to publish a written financial assistance policy, accept applications, and limit what eligible patients are charged for emergency or even medically necessary care.
In addition to those federal regulations, Texas law also expects nonprofit hospitals to provide community benefits that include charity care. This sits alongside the federal rules and underscores that hospitals in Texas must have real programs for patients who cannot afford care. You can find the community benefit requirement in the Texas Health and Safety Code and in state materials that collect the charity care provisions.
- Nonprofit hospitals in Texas do have mandated charity care requirements. Under Texas Health and Safety Code Section 311.045, nonprofit hospitals must annually satisfy community benefits and charity care requirements, and nonprofit hospitals have a legal duty to deliver charity care to demonstrate they are providing a benefit to the community they serve.
Before a hospital or a collector takes aggressive action on a bill, the hospital must first make reasonable efforts to see if you qualify for help, even such options as free government insurance in Texas. Ask the hospital’s billing office for the financial assistance application and the plain-language summary, and submit proof of income, residency, and household size.
County specific programs that help patients get help from a hospital
If you are very low income (in poverty) and not eligible for Medicaid, the County Indigent Health Care Program can be very helpful. Most counties administer a local program that covers basic services for residents who qualify. The state HHS overseas it. County indigent care programs exist but are administered locally and availability varies by county, with more details here. https://www.hhs.texas.gov/services/health/county-indigent-health-care-program.
- By statute for an indigent program, the minimum income standard is twenty one percent of the federal poverty level, with resource limits and residency rules. Apply through your county indigent health office; Texas Health and Human Services lists program details and handbooks, and 2-1-1 can route you to the right local office.
Dallas County Charity Care Program is an example. Designed to allow qualified providers to receive reimbursement for healthcare services like immunizations, public health services, and preventative services. Website: https://www.dallascounty.org/departments/dchhs/human-services/charity-care.php.
In addition to a county, large hospital districts run their own assistance programs that go beyond the state minimums. These are a form of charity care too. This can be part of the solution, or find additional ways to get help with hospital bills that are unpaid.
- Examples include the Harris Health Financial Assistance Program in Harris County, which bases eligibility on income relative to the federal poverty level and provides discounted or no-cost care to county residents.
- Baylor Scott & White Health Financial Assistance Program is for patients who satisfy certain requirements as part of their commitment to serve the community. Website: https://www.bswhealth.com/patient-tools/registration-and-billing/financial-assistance/program.
- Parkland in Dallas County offers financial assistance for people up to two hundred fifty percent of the federal poverty level.
- In Tarrant County, JPS Connection has several tiers that extend up to two hundred fifty percent of the federal poverty income level.
- University Medical Center of El Paso Charity Care has a program too. The provider offers Healthcare Options (Indigent Health Care) Program with financial assistance based on income, household size, and location UMC - El Paso. Website: https://www.umcelpaso.org/patients-and-visitors/billing-and-insurance/charity-care.
- Travis County residents may qualify for Central Health’s Medical Access Program, which connects patients to clinics, specialists, and pharmacies.
- In Bexar County, University Health’s CareLink sets affordable payment plans and discounts for uninsured residents. Each program has its own rules, but all provide structured relief if you live in the service area and meet income limits including to cancer patients and learn more on help with cancer bills.
- UT Southwestern Medical Center Financial Assistance offers charity care discounts for the medically indigent with varying percentages based on income ratios. Applicants with financial hardship may receive relief after completing an application, with eligibility reviewed and appeals available.Website: https://utswmed.org/patient-resources/billing-and-insurance/financial-assistance/.
If you do not qualify for a local program, you still have tools to bring the bill down. Nonprofit hospitals must cap what they charge financial-assistance patients for emergency and medically necessary care at no more than the amounts generally billed to insured patients. They must also describe their discounts and application steps in the policy they publish. Use the hospital’s patient estimate tool or price list to check typical charges before you schedule non-emergency care, and ask for those insurer-level rates if you qualify for the hospital’s program.
Non-profit credit counseling agencies are also located in Texas. The list of TX debt counseling organizations includes location and regional options. They offer debt relief and credit counseling services, but these are not hospital‑specific nor forgiving medical bills per se. However they can help as part of broader debt services including credit cards, consolidation, medical debt and the link.
Contact information and next steps
To put this into action, contact the hospital’s patient financial services office as soon as you receive a bill, request the financial assistance application, and submit it with proof of income. Or even better, ask in advance for a charity care option.
If you are in a county with a hospital district program, apply there as well, since enrollment can unlock lower rates within that system. While your application is pending, ask the hospital to pause collections and set a temporary interest-free payment plan. If you need help navigating options, call 2-1-1 in Texas for a referral to your county indigent health office, local navigators, and other verified resources.
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