Money & Debt

Key facts

• You have a right to receive emergency medical care. Outstanding hospital debt does not affect this right.
• Hospitals must have a written Financial Assistance Policy. This is required by the Affordable Care Act (ACA).
• The Hospital Uninsured Patient Discount Act and the Fair Patient Billing Act protect patients in Illinois.
• Nonprofit hospitals must offer charity care. For-profit and private hospitals may also have a policy that can help you.

Applying for charity care at a nonprofit hospital

1. Ask for a copy of the policy.
   • Ask for a copy of the hospital’s Financial Assistance Policy.
   • By law, the policy must be provided free of charge.
   • The policy must tell you how to apply for help.
   • You can ask if the policy is available in your preferred language.
2. Fill out an application form.
   • Use your income information when you fill out the application.
   • You may need to gather last year’s tax forms or a current pay stub.
   • You need information about your expenses, like rent, mortgage, and credit cards.
3. Ask questions.
   • Find out how long it takes to process the application.
   • Ask who to contact about your application if you have more questions.
   • Your provider should be able to tell you what happens with your bill while your application is processed.
4. Notify any debt collectors trying to collect from you that you've applied for financial assistance.
   • Tell the collector you are seeking financial assistance for the bill.
   • Instruct them to pause collections while you wait for the application to process.
5. Follow up
   • Check the status of your application.
   • If a nonprofit hospital isn't following the law about your application, tell the IRS.

Financial assistance and billing

Uninsured patients

Application for public insurance

• Hospitals must help you apply for public insurance. This includes Medicaid or Medicare.
• If you do not qualify, they must provide their own assistance resources.

Discount screening

• Hospitals must screen you for discounts before starting collections.
• Certain incomes qualify for up to a 100% discount. Check current income thresholds.

Financial assistance application

• You have at least 90 days from discharge to apply for financial assistance.
• Hospitals must respond to phone inquiries within two business days.
• Hospitals must respond to written requests within ten business days.
• Information on financial assistance must be prominently displayed in the hospital and online.
• You may receive financial assistance at any time.
• Hospitals usually require documentation to verify your financial situation.

Screening and application process

You should submit all of your financial information and documents within 30 days.

There are two different deadlines.

Under the Billing Act, you have 30 days. To be screened for financial help, you must consent and provide all necessary information within 90 days of discharge. 

Proof of income, such as tax returns and pay stubs, may be required.

Immigration concerns

If you don’t use public insurance due to immigration status, the hospital can still screen you for assistance. They can also provide immigration resources.

Payment

• Every hospital bill should include:
  • Date of services
  • Description of services
  • Amount owed
  • Hospital contact information
  • Financial assistance application information
  • Statement of itemized bill availability
• Annual payment cap
  • You only pay up to 20% of your family income for hospital services per year.
  • Tell the hospital about your discount eligibility each time you use services.
• Payment plans
  • Hospitals must offer a reasonable payment plan. To create your plan, they may consider your income, assets, amount owed, and past payments.
  • If you are insured, hospitals must give you 30 days to request a payment plan. They may not involve a collections agency during those 30 days.

Filing a complaint

You may file a complaint against the hospital if:

• The hospital does not screen you for financial assistance before starting collections, or
• You feel you were treated unfairly about your hospital bill.

The Illinois Attorney General helps with these problems. Contact them online or via their toll-free hotline (1-877-305-5145, TTY: 1-800-964-3013).

Special protections for sexual assault survivors

You're entitled to free services if you are a survivor of sexual assault. The Sexual Assault Survivors Emergency Treatment Act (SASETA) prevents billing:

• Emergency,
• Forensic,
• Transportation,
• Follow-up healthcare, and
• Medication.

Hospitals must send written notices to survivors explaining these protections. If billed, notify the hospital and the Illinois Attorney General's Crime Victim Services Division.

Enforcing your rights under the No Surprises Act

The No Surprises Act protects you from unexpected medical bills.

• Emergency services: You can't pay more than your in-network cost-sharing amount for emergency services. Even if you receive care out-of-network, you can't be charged more.
• Non-emergency services: You may receive non-emergency services from out-of-network providers at in-network facilities. For these, you can't be charged more than your in-network cost-sharing amount without prior written consent.
• Itemized bills: Get itemized bills to verify the services provided and charges made. Keep copies of:
  • All medical bills,
  • Insurance explanations of benefits (EOBs), and
  • Any communications with providers and insurers.
• Check for errors: Compare bills with your insurance policy to ensure charges are correct. Watch out for "upcoding," which is a bill for more complex or expensive services than you actually received.
• Contact your insurer: Contact your insurance company to clarify and dispute unexpected out-of-network charges.
• If you're charged the wrong amount for services, file a complaint. Contact the U.S. Department of Health and Human Services (HHS) at 1-800-985-3059.

Medical debt on credit reports

Any medical bills that you paid or under $500 should not be on your credit report.

Starting on January 1, 2025, medical debt may no longer appear on credit reports in Illinois. This information should not appear on your credit report if:

• Your medical care occurred in Illinois; or
• Your credit report was purchased or used in Illinois.

If it appears on your credit report, you should speak with a consumer advocate lawyer.

Consider bankruptcy

Bankruptcy lets you get rid of debts, stop creditor harassment, and start over financially. Medical debt is eligible for discharge in bankruptcy. Learn more about bankruptcy.

Qualified Medicare Beneficiary

If you are a Qualified Medicare Beneficiary (QMB), you cannot be charged any cost-sharing or out-of-pocket costs for covered services. Federal law prohibits collectors from trying to collect these costs. Medical providers are also required to refund any money that you paid for covered services.

If you are contacted about a charge for a covered service, you should contact the healthcare provider and remind them of your QMB status. Debt collectors who try to collect these debts are likely violating the Fair Debt Collection Practices Act (FDCPA). You may be able to find a consumer advocate lawyer willing to take your case without an up-front fee.