Washington hospital charity care policy.

Hospitals in Washington are required by the state to have a financial assistance program in place, which is also called a Charity Care policy. This will provide some qualified individuals with free or reduced priced medical care. The assistance is offered for low income and/or uninsured individuals who receive medical care in a hospital anywhere in Washington. The program is offered regardless of a patients race, background, or religion.

Every hospital in Washington is required by law to fully disclose and give patients information about their Charity Care programs. They need to do this when they ask you whether you have any existing health coverage or insurance. The state even requires that if you have trouble understanding or reading English, then the hospital will be required to give you a written translation of the application and provide a more detailed explanation of their charity care policies. Or if the hospital can’t do that, then they need to offer an interpreter who will literally read the policy to you and help you understand this information on the free medical care.

Conditions that need to be met for charity care in Washington

Residents with a total household incomes that is currently less than or equal to 100% of the Federal Government Poverty Level will not be charged anything on their medical bills and they will be entitled to receive free medical care.

More so called moderate income patients, who are considered those with incomes between 100% and 200% of federal government levels, will receive lower priced or discounted hospital care in Washington. Some of the factors that may come under review include the hospital may consider the patients total amount of savings they have and how much their assets are worth. Those are just some of the factors that will go into deciding what amounts of charity care or financial assistance a patient should be qualified for.

Some hospitals have even decided to go above and beyond these guidelines to open up the program to more people. For example, many Washington hospitals have other incomes scales in place including the following. Uninsured patients with incomes between 100% and 200% of poverty guidelines will be charged no more than the estimated cost of their medical care. Patients with no health insurance and who have incomes up to 300% FPL will be billed the same amounts as a patient with health insurance.





Note that some services will not be covered by charity care. Some medical care services you receive in the hospital from health care providers who are not considered employees will not be eligible for reduced priced or free charity care. The hospital needs, and is required by state law, to inform patients about the services you receive that are not covered by the program. In those cases, patients will be responsible for paying any bills and debts that are not covered.

State laws

Washington has rules in place that say no hospital will shall maintain or adopt policies or practices which would deny access to medical care based on a patient’s ability to pay their bill. In other words everyone is entitled to some form of medical care. Also, no hospital in Washington which maintains an emergency department shall transfer a patient who is in active labor or who has an emergency medical condition. This is only allowed in the state if the request is performed at the request of the patient. Or a transfer can occur if it is caused by limited medical resources of the transferring hospital. Hospitals must follow reasonable procedures and policies in making transfers to other hospitals or medical providers.

Patients can also apply for charity care at any time in Washington. The hospital cannot bill someone for any health care services that could be covered by free Charity Care until the application or review process has been completed. This determination will be completed when someone first goes to the hospital and receives treatment. In fact, the first bill you receive needs to be at least 14 days after the application is completed.

Also, if you pay your bill quickly, and then if the hospital approves your application for financial assistance, the hospital will then need to retroactively refund the part of your payment that should have been free.

Other state laws say that a hospital can’t deny admission to patients if they have no third-party health insurance coverage and who are unable to pay for hospital services or bills on their own. Also, hospitals need to continue to accept people in which a significant reduction in the proportion of individuals admitted for inpatient hospital services for which payment is, or is likely to be, less than the anticipated charges for or costs of such services.

There is also a formal appeal process in place. If you apply for charity care in Washington and are denied, you have the right to contest and appeal the decision. A suspension of any bills due may also occur during this appeal process.

To get more information of if you are being unfairly billed, call the Washington State Hospital Association at 206-281-7211.




By Jon McNamara

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