Prisma Health Financial Assistance: Free Care at 200% FPL + Sliding Scale Discounts (2026 Guide)
Prisma Health is the largest healthcare system in South Carolina, operating 18 hospitals and over 300 sites across the Upstate and Midlands regions. Formed from the merger of Greenville Health System and Palmetto Health, Prisma provides 100% free charity care for patients at or below 200% FPL, sliding scale discounts at 201-300% FPL, and additional hardship consideration for patients above 300% FPL. In a state that has not expanded Medicaid, Prisma's financial assistance program serves as a critical safety net for uninsured and underinsured South Carolinians.
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Quick Eligibility Summary
Who Qualifies for Prisma Health Financial Assistance?
100% Charity Care (Free)
Patients with household income at or below 200% of the Federal Poverty Level qualify for complete charity care. Your entire bill is written off. For a single person in 2026, 200% FPL is approximately $31,920/year. For a family of four, it is approximately $65,600/year. This covers services at Prisma Health hospitals and employed physician practices.
Sliding Scale Discounts (201-300% FPL)
Patients with household income between 201% and 300% FPL qualify for discounted care on a sliding scale. The higher your income within this range, the smaller the discount, but you still receive meaningful assistance. For a single person, 300% FPL is approximately $47,880/year. Financial counselors will calculate your specific discount based on your income and household size.
Hardship Consideration (Above 300% FPL)
Patients above 300% FPL may still qualify for assistance on a hardship basis. If your medical bills are large relative to your financial situation, Prisma Health will consider your application on a case-by-case basis. This is particularly relevant for patients with extended hospital stays, complex surgeries, or ongoing treatment resulting in substantial out-of-pocket costs.
Uninsured Discount
Prisma Health offers a separate uninsured discount for patients without health insurance. This discount may be applied in addition to or instead of charity care, depending on your financial situation. Ask patient financial services about the uninsured discount when you contact them.
South Carolina's Medicaid Coverage Gap (Critical for SC Patients)
South Carolina has not expanded Medicaid under the Affordable Care Act. This creates a coverage gap that affects approximately 130,000 South Carolina adults. These are people who earn too much to qualify for traditional Medicaid but too little to qualify for marketplace insurance subsidies (generally below 100% FPL).
If you fall in this coverage gap, Prisma Health financial assistance is one of your most important resources. Patients in the coverage gap almost always qualify for 100% free charity care at Prisma, since the gap primarily affects people well below the 200% FPL threshold.
You may be in the coverage gap if:
- You are an adult between 19 and 64 without dependent children (or with children but earning above SC Medicaid limits)
- Your income is below approximately $15,960/year for a single person
- You applied for Medicaid and were denied, and you cannot afford marketplace insurance
- You do not qualify for Medicare, disability, or other government health programs
What to do: Contact Prisma Health Patient Financial Services at (864) 455-7575. Explain that you are uninsured and may be in the Medicaid coverage gap. They can help you apply for financial assistance and explore all available options. Prisma also uses proactive screening, so they may already be trying to reach you.
Need Help with a Prisma Health Bill?
CareRoute can help you understand your options, draft appeal letters, and navigate the financial assistance application process. Our tools are designed to help patients advocate for themselves effectively.
Try Bill DefenseMerger Billing: Greenville Health System and Palmetto Health
Prisma Health was formed in 2017 from the merger of Greenville Health System (Upstate) and Palmetto Health (Midlands/Columbia). While the systems are now unified under the Prisma Health name, billing can still be complex. Some patients receive bills referencing the legacy names, and separate billing systems may still be in use for certain departments.
How to protect yourself:
- When applying for financial assistance, list all account numbers from every Prisma, Greenville Health, and Palmetto Health bill you have received
- Ask your financial counselor to confirm your application covers both facility charges and professional (physician) charges
- If you receive a bill from a Prisma-employed physician that seems separate, contact patient financial services to confirm it is included in your FA application
- Keep copies of all bills and correspondence, organized by which entity sent them
Separate Physician Billing (Important Warning)
Some physicians at Prisma Health facilities may bill separately from the hospital. This is common across large health systems, but it catches many patients by surprise. You might receive a hospital facility bill from Prisma Health and a separate professional services bill from an individual physician or physician group.
What to know:
- Prisma Health financial assistance covers Prisma hospitals and employed physician practices
- Independent physicians who practice at Prisma facilities may have their own billing and financial assistance policies
- If you receive a separate physician bill, call the number on that bill and ask if they participate in Prisma Health financial assistance
- If they do not, ask about their own financial assistance or hardship programs
Tip: When you check in at a Prisma facility, ask the registration desk whether all providers you will see are Prisma-employed. This helps you anticipate which bills will be covered under a single financial assistance application.
Proactive Screening (Prisma May Already Be Looking for You)
Prisma Health uses data analytics to identify patients who may qualify for Medicaid or financial assistance. If their systems flag you as potentially eligible, a financial counselor may reach out to you proactively. This is an unusual and patient-friendly practice.
However, do not rely solely on proactive screening. Not every eligible patient is flagged, and the process takes time. If you have a bill you cannot afford, contact patient financial services directly rather than waiting to be contacted.
If Prisma contacts you: Respond promptly. They may be trying to help you qualify for Medicaid, financial assistance, or other programs. Ignoring outreach from Prisma financial services could mean missing help that was coming your way.
Prisma Health Upstate Facilities (Greenville Region)
Prisma Health Greenville Memorial
Greenville, SC
Flagship hospital, Level I trauma center, and academic medical center
Prisma Health Patewood
Greenville, SC
Specialty hospital for heart, orthopedic, and surgical care
Prisma Health Greer Memorial
Greer, SC
Community hospital serving the Greer and Taylors area
Prisma Health Hillcrest
Simpsonville, SC
Community hospital serving southern Greenville County
Prisma Health Oconee Memorial
Seneca, SC
Serving Oconee County and the Lake Keowee area
Prisma Health Baptist Easley
Easley, SC
Community hospital serving Pickens County
All Upstate Prisma Health facilities (formerly Greenville Health System) follow the same financial assistance policy. Your application applies across all Upstate locations.
Prisma Health Midlands Facilities (Columbia Region)
Prisma Health Richland
Columbia, SC
Major medical center and Level I trauma center in the Midlands
Prisma Health Baptist
Columbia, SC
Full-service hospital in downtown Columbia
Prisma Health Baptist Parkridge
Columbia, SC
Hospital campus in northeast Columbia
Prisma Health Tuomey
Sumter, SC
Serving the Sumter and surrounding communities
Prisma Health Toumey
Kershaw County area
Additional Midlands community facilities
Prisma Health North Knightsville
Columbia, SC area
Freestanding emergency department and outpatient services
All Midlands Prisma Health facilities (formerly Palmetto Health) follow the same financial assistance policy. If you received care at a Palmetto Health facility before the merger, contact Prisma financial services for help with those accounts.
How to Apply for Prisma Health Financial Assistance
Contact Patient Financial Services
Call Prisma Health Patient Financial Services at (864) 455-7575 or visit the financial counseling office at your Prisma facility. You can also ask at the registration desk, ER, or business office. Financial counselors are available at all Prisma Health locations in both the Upstate and Midlands.
Gather Your Documents
You will typically need: proof of income (pay stubs, tax returns, or a statement of no income), proof of household size, government-issued ID, and all Prisma Health bills or account numbers. Include bills from any legacy Greenville Health System or Palmetto Health accounts. Your counselor will confirm exactly what is needed.
Ask About Medicaid and Other Programs
Before completing the financial assistance application, ask your counselor to check if you qualify for South Carolina Medicaid, the SC Healthy Connections program, or other government assistance. Prisma counselors can help you apply for these programs. If approved for Medicaid, it may cover your bills retroactively.
Complete the Financial Assistance Application
Fill out the Prisma Health financial assistance application form with your counselor's help. Make sure all Prisma entities and account numbers are listed on a single application. Ask specifically whether facility and professional (physician) charges are both covered.
Submit and Follow Up
Submit your completed application with all documentation to patient financial services. Keep copies of everything you submit. Follow up within 2 weeks if you have not received confirmation of receipt. Ask for a written acknowledgment that your application has been received.
Receive Your Determination
Prisma Health will review your application and notify you of the decision. If approved for 100% charity care, your entire balance will be written off. If approved for the sliding scale, the discount will be applied to your eligible bills. If you qualify for the uninsured discount, that will be applied as well.
If Your Application Is Denied
If Prisma Health denies your financial assistance application, you have options:
- 1.Request a written explanation of the denial reason. Understanding why helps you address the issue directly.
- 2.Appeal the decision. Ask your financial counselor about the appeal process. Provide additional documentation that addresses the specific denial reason.
- 3.Request hardship consideration. If you were denied based on income alone but your bills are substantial, ask about the hardship provision for patients above 300% FPL.
- 4.Ask about the uninsured discount. Even without charity care approval, uninsured patients may still qualify for a separate discount on their bills.
- 5.Request a payment plan. Prisma Health may offer interest-free or reduced payment plans even if charity care is not approved.
- 6.Contact the SC Department of Consumer Affairs or the state Attorney General if you believe the denial violates nonprofit hospital obligations. Prisma must comply with IRS 501(r) requirements as a tax-exempt organization.
Denied? Let Us Help You Appeal
CareRoute can help you draft an appeal letter, identify the right provisions to cite, and build a compelling case for why your application should be reconsidered.
Start Your Appeal with Bill DefenseSouth Carolina Medical Debt Protections
South Carolina provides several important protections for patients with medical debt. Knowing these can help you navigate your Prisma Health bills more effectively.
3-Year Statute of Limitations
South Carolina has a 3-year statute of limitations on medical debt. This is shorter than most states. After 3 years, a creditor generally cannot sue you to collect the debt. The clock starts from the date of your last payment or the date the debt became due. Do not make a partial payment on old debt without understanding the implications, as it may reset the clock.
Medical Debt and Credit Reports
South Carolina is considering legislation to ban medical debt from credit reports. While this is not yet law as of 2026, national credit bureau changes have already removed paid medical debt and medical debt under $500 from credit reports. Track this legislation, as it could provide additional protection for Prisma Health patients.
Nonprofit Hospital Obligations
As a nonprofit, tax-exempt health system, Prisma Health must comply with IRS Section 501(r). This means they are required to have a financial assistance policy, make it widely publicized, provide a plain-language summary, and limit charges for patients who qualify for assistance. If you believe Prisma is not following these requirements, you can file a complaint with the IRS or the SC Attorney General.
Contact Information
Prisma Health Patient Financial Services can help you with financial assistance applications, payment plans, billing questions, and Medicaid enrollment assistance.
Frequently Asked Questions
Who qualifies for free care at Prisma Health?
Patients with household income at or below 200% of the Federal Poverty Level qualify for 100% free charity care at Prisma Health facilities. This is approximately $31,920/year for a single person or $65,600/year for a family of four in 2026. Both insured and uninsured patients can qualify.
What if I fall in South Carolina's Medicaid coverage gap?
South Carolina has not expanded Medicaid, leaving about 130,000 adults in a coverage gap. If you earn too much for traditional Medicaid but too little for marketplace subsidies, Prisma Health financial assistance is one of your best options. Patients in this gap typically qualify for 100% free charity care since their income is well below 200% FPL. Contact Prisma at (864) 455-7575 to apply.
I got a bill from Greenville Health System or Palmetto Health. Is that Prisma?
Yes. Prisma Health was formed from the 2017 merger of Greenville Health System (Upstate) and Palmetto Health (Midlands). Some billing systems still use legacy names. Prisma financial assistance covers all entities in the system. When applying, list all account numbers from every bill you have received, regardless of which name appears on it.
Does Prisma Health offer an uninsured discount?
Yes. Prisma Health provides an uninsured discount that is separate from the charity care program. Uninsured patients may receive a discount on their bills even before applying for financial assistance. Ask patient financial services about this when you call. You may be eligible for both the uninsured discount and charity care.
Does Prisma Health proactively screen patients for assistance?
Yes. Prisma Health uses data analytics to identify patients who may qualify for Medicaid or financial assistance and may reach out proactively. However, not every eligible patient is flagged automatically. Always apply on your own rather than waiting to be contacted.
Can Prisma Health help me enroll in Medicaid?
Yes. Prisma Health financial counselors can help you determine if you qualify for South Carolina Medicaid (SC Healthy Connections) and assist with the enrollment process. They can also help with marketplace insurance applications. Even if Medicaid is denied, you can still apply for Prisma financial assistance.
What is the statute of limitations on medical debt in South Carolina?
South Carolina has a 3-year statute of limitations on medical debt, which is shorter than most states. After 3 years from your last payment or the date the debt became due, a creditor generally cannot sue you to collect. Be cautious about making partial payments on old debt, as this may restart the clock.
What about separate physician bills from Prisma facilities?
Prisma Health financial assistance covers Prisma hospitals and employed physician practices. However, some physicians at Prisma facilities may bill independently. If you receive a separate physician bill, call the number on that bill to ask if they participate in Prisma financial assistance. If not, ask about their own hardship or financial assistance programs.
Related Guides
Your state may provide additional protections for medical bills beyond what Prisma Health offers through its financial assistance program. Other health systems in the region may also offer assistance.
Last updated: May 2026. Information is based on publicly available Prisma Health financial assistance policies. Always confirm current eligibility requirements directly with Prisma Health Patient Financial Services at (864) 455-7575.