FREE or low-cost hospital care in Maryland

Maryland at a glance

Maryland is home to about 1,030,670 foreign-born residents (16.6% of the state’s 6,206,011 people) and 774,946 residents of Hispanic or Latino origin (12.5%), per the U.S. Census Bureau’s American Community Survey (2024 5-year estimates). The procedures below apply to everyone in Maryland regardless of immigration status unless noted.

If you live in Maryland and need medical care but DON’T have insurance and CAN’T pay, there are multiple programs to help.

Hospital charity-care law — Maryland
State law?Yes — Maryland hospital financial assistance law (expanded by HB 1420) (Md. Code, Health-General §19-214.1); covers: all acute-care and chronic-care hospitals
Free careIncome up to 200% FPL — about $66,000/year for a household of 4 (2026 guidelines)
Discounted careUp to 500% FPL — about $165,000/year for a household of 4
What it meansHospitals must give free medically necessary care below 200% FPL and sliding discounts (75% down to 35%) from 201% up to 500% FPL — the 301–500% tiers for patients with financial hardship. Patients have 240 days to apply; only assets over $100,000 are counted. Applies regardless of immigration status.
Verifymgaleg.maryland.gov

State laws verified 2026-06-10. Charity-care laws are actively changing — confirm the current rule with the hospital before making decisions.

EMTALA — Emergency Medical Treatment and Labor Act

Federal law requires ALL hospitals with emergency rooms to:

  • Examine anyone arriving with emergency
  • Stabilize emergency BEFORE any payment consideration
  • CANNOT ask immigration status before treating
  • CANNOT demand payment before stabilizing

This INCLUDES childbirth. If you arrive in labor, they must treat you.

Nonprofit hospitals and Charity Care (IRS Section 501(r))

Nonprofit hospitals (most in Maryland) MUST, by federal law:

  • Have a published financial assistance policy
  • Offer discounts to low-income patients
  • NOT charge more than “amounts generally billed” (AGB) to eligible patients
  • Notify patient about Charity Care BEFORE sending bills to collections

Common Charity Care programs

Income-based sliding scale discounts

Most nonprofit hospitals in Maryland offer:

  • 0-200% FPL (up to $31,920 for one person, 2026): FREE (100% discount)
  • 200-400% FPL (up to $63,840 ): 50-75% discount
  • 400-600% FPL (up to $95,760 ): 25-50% discount
  • Above 600% FPL: negotiated price but NO Charity Care

How to apply

  1. Request application at hospital billing department
  2. Simple form — typically 2-4 pages
  3. Documents: income proof (W-2, 1099, paystubs, ITIN tax return), proof of essential expenses (rent, food), family composition
  4. No mandatory SSN — can use ITIN or alternative ID
  5. Applies retroactively — if you receive bill, can apply AFTER treatment

Timeline

  • At least 240 days from the first bill after discharge — the federal 501(r) minimum application window
  • Many hospitals allow even longer
  • If your bill is already in collections, you can STILL apply

Public / safety net hospitals in Maryland

Large states have public hospital systems treating everyone regardless of ability to pay:

  • County hospitals
  • Public Hospital Districts
  • Veterans Administration (veterans only)
  • Indian Health Service (Native Americans)

These hospitals typically:

  • Treat ALL, especially uninsured
  • Have sliding fee scales
  • Have interpreters in multiple languages (Spanish included)
  • Connect with social services

Community Health Centers (FQHC)

See: Community Health Centers in Maryland

If no emergency (routine care)

  • Medicaid (if eligible): /benefits/medicaid/maryland/
  • CHIP for your kids: /benefits/chip/maryland/
  • Marketplace plans (healthcare.gov) — note: DACA recipients were briefly eligible under a 2024 rule, but a 2025 federal rule excluded them again
  • FQHC sliding scale (Federally Qualified Health Centers)
  • Free clinics — search in your area
  • Dental/vision services at medical/dental schools (low prices)

What to do if you receive an impossible medical bill

  1. DON’T IGNORE — leads to collections and credit damage
  2. Call hospital and ask for “Financial Assistance Application” or “Charity Care application”
  3. Negotiate — hospitals often accept 10-50% of bill as final payment
  4. Interest-free installments — most offer this
  5. DON’T use credit card to pay hospital bills — loses nonprofit billing protection
  6. Consult pro bono attorney if threatened with garnishment (some hospitals do this illegally)

Resources

Last verified: 2026-06-15.

General information, not medical or legal advice. For specific situations, talk to a Patient Advocate or insurance attorney.