MedStar Health Financial Assistance: Free Care at 200% FPL + 25% Income Test to 500% FPL (2026 Guide)
MedStar Health is the largest healthcare provider in the Maryland and DC region, operating 10 hospitals. Their financial assistance program offers 100% free care for patients at or below 200% of the Federal Poverty Level, reduced-cost care up to 400% FPL, and a unique 25% income test that extends eligibility to 500% FPL for families facing catastrophic medical costs. MedStar uses the Maryland State Uniform Financial Assistance Application, a standardized and simplified process.
Quick Eligibility Summary
Who Qualifies for MedStar Health Financial Assistance?
MedStar Health provides financial assistance based on Federal Poverty Level (FPL) guidelines. The program has three tiers of eligibility:
Tier 1: 100% Free Care (0-200% FPL)
Patients with household income at or below 200% of the Federal Poverty Level receive complete write-off of their medical bills. For a single person in 2026, this is approximately $31,920/year. For a family of four, approximately $66,000/year.
Tier 2: Reduced-Cost Care (201-400% FPL)
Patients between 201% and 400% FPL receive reduced-cost care. Under this tier, patient charges will not exceed the amounts generally billed to insured patients (AGB, or "amounts generally billed"). This is a significant protection, as uninsured patients are often charged much higher "chargemaster" rates without this provision.
Tier 3: 25% Income Test (Up to 500% FPL)
Even if your income exceeds the standard thresholds, you may qualify if your medical debt over a 12-month period exceeds 25% of your family income. This extends eligibility up to 500% FPL. See the detailed explanation below.
The 25% Income Test Explained
Key Insight: Higher-Income Families Can Still Qualify
This is one of the most generous provisions in any hospital financial assistance program. If your total medical debt over a 12-month period exceeds 25% of your family's annual income, you qualify for financial assistance even if your income is above the standard 400% FPL cutoff.
Example Scenario:
- 1.Family of four earning $150,000/year (well above 400% FPL)
- 2.Incurs $45,000 in medical bills over 12 months (a surgery plus complications)
- 3.$45,000 is 30% of $150,000 (exceeds the 25% threshold)
- 4.This family qualifies for financial assistance under the 25% income test
This provision recognizes that medical costs can be catastrophic for any family, not just those with low incomes. If you have had a major hospitalization, surgery, or extended treatment, calculate whether your total bills exceed 25% of your household income over the past 12 months.
Not sure if you qualify? Get a free bill analysis.
CareRoute can review your MedStar bills and determine which financial assistance tier applies to your situation, including the 25% income test. Our team identifies billing errors, overcharges, and assistance eligibility you may have missed.
Start Free Bill DefenseMaryland's Unique All-Payer System (HSCRC)
Maryland is the only state in the nation that operates under the Health Services Cost Review Commission (HSCRC) all-payer rate system. This means:
- Regulated rates: Hospital rates are set by the state commission, not by individual hospitals. All payers (including Medicare and Medicaid) pay the same rates at each hospital.
- Transparency: Because rates are standardized, there is no "chargemaster" price inflation at Maryland hospitals the way there is in other states.
- Financial assistance still matters: Even with regulated rates, hospital bills can be substantial. The HSCRC system does not eliminate the need for charity care for uninsured or underinsured patients.
- Uniform application: Maryland requires all hospitals to use the same standardized financial assistance application form, making the process simpler and more consistent.
Note: MedStar facilities in DC and Virginia are not subject to HSCRC regulation, but MedStar applies its financial assistance policy across all locations.
Presumptive Eligibility: Qualify Without a Full Application
MedStar Health offers presumptive eligibility, meaning certain patients can be approved for financial assistance without completing the full application process. You may be presumptively eligible if:
- You are enrolled in Medicaid, SNAP, WIC, or other means-tested government programs
- You are experiencing homelessness
- You are deceased with no estate
- You qualify based on data available from third-party verification tools
If presumptive eligibility applies to you, inform the financial counselor when you call. This can significantly speed up the approval process.
Covered MedStar Health Facilities (All 10 Hospitals)
MedStar Health's financial assistance policy covers all 10 hospitals in the system across Maryland, Washington DC, and Northern Virginia:
How to Apply for MedStar Health Financial Assistance
Check Your Eligibility
Review the income thresholds above. Remember the three tiers: 100% free care at 200% FPL, reduced-cost at 201-400% FPL, and the 25% income test up to 500% FPL. Use the FPL table above to check where your household falls.
Contact Financial Counseling
Call (410) 933-4966 or the toll-free number (844) 817-6087. A financial counselor can help determine your eligibility, explain what documentation you need, and guide you through the application.
Complete the Maryland Uniform Application
MedStar uses the Maryland State Uniform Financial Assistance Application. This is a standardized form used by all Maryland hospitals, designed to be straightforward. The policy states that documentation requirements should not present an "undue barrier" to patients seeking assistance.
Submit Your Application
Submit by mail, in person at any MedStar facility, or by fax. Include basic income documentation (pay stubs, tax return, or benefit statements). Keep copies of everything you submit.
Follow Up
Call back after 7-10 business days to confirm your application was received and to check on its status. If additional documentation is requested, respond promptly to avoid delays.
If Your Application Is Denied
If MedStar denies your financial assistance application, you have options:
- Request a written denial: Ask for the specific reason in writing. Common reasons include incomplete applications or missing documentation.
- Appeal the decision: You have the right to appeal. Provide any additional documentation that addresses the reason for denial.
- Invoke the 25% income test: If you were denied based on income but your medical bills exceed 25% of your annual income over 12 months, specifically request review under this provision.
- Contact the HSCRC: In Maryland, you can file a complaint with the Health Services Cost Review Commission if you believe the hospital is not following its financial assistance obligations.
- Request a payment plan: Even if you do not qualify for charity care, you may be able to negotiate a manageable payment plan or reduced balance.
Denied? We can help you appeal.
CareRoute has helped patients successfully appeal financial assistance denials at MedStar Health. We know the specific documentation and language that works, including how to invoke the 25% income test and Maryland HSCRC protections.
Get Help With Your AppealMedStar Health Contact Information
(410) 933-4966
(844) 817-6087
medstarhealth.org
Frequently Asked Questions
Who qualifies for MedStar Health financial assistance?
Patients with household income at or below 200% of the Federal Poverty Level qualify for 100% free care. Those between 201-400% FPL receive reduced-cost care (charges capped at amounts generally billed to insured patients). Patients up to 500% FPL may qualify through the 25% income test if medical debt over 12 months exceeds 25% of family income.
What is the 25% income test?
If your total medical debt over a 12-month period exceeds 25% of your family's annual income, you may qualify for financial assistance even if your income is above the standard 400% FPL threshold. This extends eligibility up to 500% FPL and is designed to protect families facing catastrophic medical costs.
What is the Maryland Uniform Financial Assistance Application?
Maryland requires all hospitals in the state to use the same standardized financial assistance application form. This makes the process simpler and more consistent than in other states where each hospital has its own form. The application is designed to minimize documentation barriers.
What is presumptive eligibility?
Presumptive eligibility allows MedStar to approve financial assistance without a full application in certain cases. If you are enrolled in Medicaid, SNAP, WIC, or other means-tested programs (or experiencing homelessness), you may be automatically approved. Ask the financial counselor about this when you call.
How does the HSCRC all-payer system affect my bills?
The Health Services Cost Review Commission sets hospital rates in Maryland, so all payers (including Medicare) pay the same rates. This means hospital pricing is more transparent and regulated than in other states. However, regulated rates can still be unaffordable for uninsured or underinsured patients, making financial assistance essential.
Can I get financial assistance if I live in DC or Virginia?
Yes. MedStar Health serves patients across Maryland, Washington DC, and Northern Virginia. Financial assistance is available regardless of where you live, as long as you received care at a MedStar facility. MedStar Washington Hospital Center and MedStar Georgetown both serve many DC and Virginia residents.
What documentation do I need?
MedStar's policy states that documentation requirements should not present an "undue barrier" to patients. Typically you will need basic income verification such as pay stubs, tax returns, or benefit statements. The financial counselor can advise on the minimum documentation needed for your specific situation.
What does "will not exceed amounts generally billed" mean?
For patients in the 201-400% FPL tier, MedStar will not charge more than the AGB (amounts generally billed), which is the average amount paid by insured patients. This protects you from inflated "list prices" that are sometimes charged to uninsured patients. Your bill is capped at what insurance companies typically pay for the same services.
Related Resources
Last updated: May 2026. Information is based on MedStar Health's publicly available financial assistance policy. Policies may change. Always confirm current eligibility requirements directly with MedStar Health.