Memorial Hermann Financial Assistance (Charity Care): Complete 2026 Guide
Memorial Hermann offers financial assistance for emergency and medically necessary care across its Houston-area hospitals. This guide explains eligibility, required documents, and exactly how to submit the application.
Quick Facts
Emergency & Medically Necessary Care
Assistance typically applies to qualifying hospital services
Income-Based Tiers
Free or discounted care based on income and circumstances
Apply on Time
Follow the deadline listed on your application or billing statement
713-338-5502
Customer Service (also 1-800-526-2121, option 5)
Memorial Hermann Houston-Area Hospitals
Memorial Hermann operates multiple hospitals and clinics across Greater Houston. Financial assistance details can vary by facility and provider group, so confirm the policy for the hospital listed on your statement.
Main Hospital Phone Numbers
Note: Some providers may bill separately and may not be covered by the hospital policy. Always confirm coverage and provider participation before submitting your application.
Eligibility & Income Limits (2026 Federal Poverty Guidelines)
Memorial Hermann evaluates income, assets, household size, insurance status, and other circumstances. The system uses a Federal Poverty Guidelines income table that is updated annually (see Exhibit C on the official policy page). Use the official table for current eligibility limits for your facility.
Where to Find the Income Table
Memorial Hermann publishes its income eligibility table as Exhibit C (Federal Poverty Guidelines) in the Financial Assistance Program documents. Use the official document for the current year’s limits.
Important Notes:
- • Income limits are updated annually in the official policy documents
- • Applicants are expected to apply for all possible insurance coverage, including Medicaid, when required
- • Memorial Hermann’s summary notes: ≤200% FPL may qualify for a 100% discount; above 200% may qualify for a discount
- • Some patients may qualify above standard income tiers due to hardship or high medical bills
- • Not all locations and services listed on Memorial Hermann’s website are covered by the Financial Assistance Policy
- • Financial assistance applies to emergency and medically necessary care only
- • Eligibility is also based on assets, insurance status, and other factors beyond income
- • Memorial Hermann may review credit reports, property tax records, or other documents when determining eligibility
- • Some applicants may be required to complete Medicaid screening
Additional Ways to Qualify
Presumptive Eligibility
Some facilities may use available information to preliminarily assess eligibility. If you appear eligible or ineligible for Medicaid, the hospital may proceed with financial assistance review without a full Medicaid application.
Special Circumstances & Hardship
If your situation includes recent job loss, disability, terminal illness, or other hardship, submit documentation. Hospitals can consider case-by-case factors beyond standard income guidelines.
Insured & Underinsured Patients
You may still qualify even if you have insurance. If benefits are exhausted, services are not covered, or your out-of-pocket costs are unaffordable, you can apply for assistance on the remaining balance.
Required Documents Checklist
Income Verification
- Most current federal income tax return (if filed)
- Last two employer pay stubs (if applicable)
- Written documentation for other income sources or benefits
Assets & Accounts
- Bank statements (last three months)
Household & Identity
- Proof of household size and residency
- Photo ID for the applicant or head of household
Required documents can vary by facility. Follow the checklist on your application and submit copies, not originals.
How to Apply (Step-by-Step)
Identify Your Facility and Bill
Use your billing statement to confirm the exact facility and the financial assistance form you need.
5 minutes
Gather Documents
Collect the required documents from the checklist above. You can request a free paper copy of the application in Emergency Center and Registration Areas.
15 minutes
Submit Your Application
Complete the application and submit it by the method listed on your form (mail, fax, or email).
20 minutes
Complete Medicaid Screening if Required
Follow any instructions for Medicaid or other coverage screening.
Varies
Follow Up
Call Patient Financial Services to confirm receipt and ask about next steps.
Ongoing
Tips for a Smooth Application
✓ Use the Correct Form
Facilities may use different applications or addresses. Use the form linked to your bill.
✓ Send Complete Documentation
Missing documents are the most common reason applications are delayed.
✓ Apply Within the Deadline
Use the deadline listed on your statement or application to avoid collections.
✓ Keep Copies
Save copies of everything you submit, including any fax confirmations.
Contacts & Official Links
Customer Service / Financial Assistance
Request the Financial Information Form or ask for assistance
Mailing Address
Use the address on your application if it differs
Fax or Email
In-Person Assistance
Financial counselors are available at each hospital to help evaluate eligibility.
Frequently Asked Questions
Who qualifies for Memorial Hermann financial assistance?
What care is covered by Memorial Hermann financial assistance?
How do I apply?
Do I need to apply for Medicaid first?
Which locations are covered?
Next Steps
Related Resources:
Disclaimer: This information is provided for educational purposes only and is not legal or financial advice. Eligibility requirements and processes may change. Always confirm current policies directly with Memorial Hermann.CareRoute is not affiliated with Memorial Hermann or Memorial Hermann Health System.