ProMedica Financial Assistance: Free Care Under 200% FPL + 78% Discount Up to 400% FPL (2026 Guide)
ProMedica is a nonprofit health system with 10 hospitals across Ohio and Michigan, headquartered in Toledo. They offer 100% free care for households under 200% FPL and charge only 22% of gross charges (a 78% discount) for 201-400% FPL. In 2024, ProMedica partnered with the City of Toledo to forgive $222 million in patient debt. Ohio provides up to $182,625 in homestead protection and a 6-year statute of limitations on medical debt.
Quick Eligibility Snapshot
100% Free Care: Under 200% FPL
Full write-off of eligible charges for households at or below 200% FPL. Family of 4: up to ~$62,400/year (2025 guidelines).
78% Discount: 201-400% FPL
Patients are billed only 22% of gross charges. This flat-rate discount is unusually generous compared to most hospital systems nationwide.
$222M Debt Forgiven (2024)
Partnership with City of Toledo and Undue Medical Debt. 108,737 patients had debt eliminated. Toledo bought $69M in debt for just $800K.
10 Hospitals in OH and MI
From Toledo Hospital (flagship) to critical access facilities. Financial assistance applies system-wide across all ProMedica hospitals.
Who Qualifies for Financial Assistance?
Two-Tier Income-Based System
- Tier 1 (free care): Households at or below 200% FPL receive a 100% write-off of eligible charges. No balance owed.
- Tier 2 (78% discount): Households between 201% and 400% FPL are billed only 22% of gross charges. On a $10,000 bill, you would owe only $2,200.
- Ohio HCAP (separate program): Ohio residents at or below 100% FPL may also qualify for the state Hospital Care Assurance Program, which provides free hospital services independently of ProMedica's own policy.
- Email submission accepted: Unlike most systems that require mail or fax only, ProMedica accepts applications via email (financial.assist@promedica.org).
- Covers medically necessary services at all ProMedica facilities in Ohio and Michigan.
Context: ProMedica's Financial Recovery
ProMedica experienced major financial distress from 2022 to 2024, losing $470.9M in 2022 and divesting 147 skilled nursing facilities. The system is now recovering ($79.7M income in 2024) but remains below investment grade (Ba1 rating). However, financial assistance is federally mandated under 501(r) regulations. Regardless of a hospital's financial health, they are legally required to maintain and honor their charity care programs.
How to Apply (Step by Step)
Use the Online Eligibility Screener
ProMedica offers an instant online pre-qualification tool. This gives you a preliminary answer about whether you qualify before you gather documents. Visit promedica.org or call to ask about the screener link.
Determine Your FPL Level
Under 200% FPL = 100% free care. Between 201-400% FPL = you pay only 22% of charges (78% discount). Use the FPL table above to check where your household falls.
Gather Documents
Collect proof of income (recent pay stubs, tax return, or benefits statements), proof of household size, and your ProMedica account number. Have identification ready.
Submit Your Application
Submit by email (financial.assist@promedica.org), mail, fax, or in person at any ProMedica facility. Email submission is accepted, which is unusual and much faster than most hospital systems.
Follow Up
Call 1-844-373-0871 (Mon-Fri, 8am-4:30pm) to check status. You have 240 days from the first billing statement to apply, even if the account has already been sent to collections.
Pro Tips
- Dollar For will help for free: The nonprofit dollarfor.org helps patients at ProMedica facilities with financial assistance applications at no cost.
- Email is fastest: Since ProMedica accepts email submissions, you can send your application and supporting documents digitally for faster processing.
- Ohio HCAP is separate: If you are at or below 100% FPL and an Ohio resident, ask about HCAP enrollment as well. This state program operates independently.
- Already in collections? Federal 501(r) rules require ProMedica to process your application within 240 days of the first bill. If approved, they must recall the account from collections.
Ohio State Protections for Medical Debt
Ohio provides meaningful protections for patients facing medical debt. Know your rights regardless of whether you qualify for ProMedica's financial assistance program.
$182,625 Homestead
Ohio protects up to $182,625 in home equity from creditor judgments (increased April 2025). A lien can be placed, but a forced sale is delayed while you maintain homestead status.
6-Year SOL
Creditors have 6 years to file a lawsuit on medical debt (written contract). After that, the debt is time-barred and cannot be enforced through the courts.
Ohio HCAP Program
State-funded program providing free hospital services to Ohio residents at or below 100% FPL. This is separate from and in addition to ProMedica's own financial assistance.
Learn more: See our Ohio Medical Bill Rights Guide for a complete overview of state protections, garnishment limits, and exemptions.
Covered Facilities
ProMedica Hospitals (10 Total, OH and MI)
ProMedica's financial assistance policy applies to all facilities system-wide, including emergency departments, outpatient services, and physician practices within the system.
Michigan Patients: Different State Protections
If you received care at Monroe Regional or Hickman Hospital in Michigan, your state protections differ from Ohio. Michigan has a 6-year SOL and $40,475 homestead exemption. ProMedica's financial assistance policy itself is the same regardless of which state the hospital is in.
Collections Policy
Low Risk: No Evidence of Aggressive Litigation
ProMedica has not been found to engage in mass patient lawsuits. Unlike some Ohio systems (such as Mary Rutan Hospital, which sued 2,700 patients in 2 years), there is no public evidence of ProMedica pursuing aggressive courtroom collection strategies. Their 2024 $222M debt forgiveness further demonstrates a patient-favorable approach.
Collection Timeline
- 0-120 days: Internal billing with financial assistance information included
- After 120 days: May refer to outside collection agency
- 240-day window: You can still apply for financial assistance within 240 days of the first bill, even if already in collections
- 30-day ECA notice: Must provide 30-day written warning before any extraordinary collection action (liens, lawsuits, credit reporting)
$222M Debt Forgiveness (2024)
In 2024, ProMedica partnered with the City of Toledo, Lucas County, and nonprofit Undue Medical Debt to eliminate $222 million in patient debt for 108,737 people. The City of Toledo purchased $69 million in debt for just $800,000 (about 1.2 cents per dollar). Patients whose debt was purchased received notification that their balance was eliminated with no tax consequences.
Ohio Protections Against Collections
- $182,625 homestead: Home equity protected up to this amount (as of April 2025). Liens can be placed but forced sale is delayed.
- 6-year SOL: After 6 years without a payment or lawsuit, the debt cannot be legally enforced
- Wage garnishment: Limited to 25% of disposable earnings or the amount above 30x minimum wage, whichever is less
Already in collections? Read our full 7-step collections playbook for strategies to resolve medical debt, dispute errors, and negotiate settlements.
What If You Are Denied?
1. Ask Why and Resubmit
If denied for missing or incomplete documents, ask exactly what is needed and resubmit. ProMedica accepts email (financial.assist@promedica.org), making resubmission quick.
2. Check Ohio HCAP Separately
If you are at or below 100% FPL and an Ohio resident, you may qualify for the state HCAP program even if ProMedica's internal FAP denies you. Ask the hospital about HCAP enrollment specifically.
3. Negotiate a Payment Plan
If you fall above 400% FPL, ask about interest-free payment plans. ProMedica may offer extended terms. Even without financial assistance, you can often negotiate the total amount owed.
4. Get Free Help
- Dollar For (dollarfor.org): Free nonprofit advocacy for ProMedica financial assistance applications
- Ohio Medicaid: May retroactively cover bills up to 3 months prior to application
- Legal Aid of Western Ohio: Free legal help for low-income patients facing collections or lawsuits
Let CareRoute Bill Defense Help
If your application was denied or you need help negotiating your ProMedica bill, CareRoute Bill Defense can review your case and negotiate on your behalf at no upfront cost.
Get Help with Your BillContact Information
Financial Assistance Office
Phone: 1-844-373-0871 (toll-free)
Hours: Mon-Fri, 8am-4:30pm
Email: financial.assist@promedica.org
Online Resources
Online eligibility screener, application PDF, and full policy document available. Email submission accepted for faster processing.
Frequently Asked Questions
What does "billed only 22% of gross charges" mean?
If your hospital bill is $10,000 and you qualify at 201-400% FPL, ProMedica will charge you only $2,200 (22% of the total). The other $7,800 is written off. This is a flat percentage applied to all eligible charges, making it one of the most generous sliding-scale discounts in the region.
Can I apply after my bill goes to collections?
Yes. Federal 501(r) regulations require ProMedica to accept and process applications for 240 days after the first billing statement. If approved, the hospital must recall the account from collections and apply the write-off.
Is ProMedica financially stable enough to honor charity care?
ProMedica experienced significant losses in 2022-2023 but returned to profitability in 2024 ($79.7M net income). Regardless of financial health, 501(r) regulations legally require nonprofit hospitals to maintain and honor their financial assistance programs. Your application will be processed the same way regardless of the system's financial situation.
What is the Ohio HCAP program?
The Hospital Care Assurance Program (HCAP) is an Ohio state program that provides free hospital services to residents at or below 100% FPL. It is funded by the state and operates separately from ProMedica's internal financial assistance. You can qualify for both. Ask the hospital about HCAP enrollment if you are below 100% FPL.
Can ProMedica put a lien on my home in Ohio?
Ohio protects up to $182,625 in home equity (increased April 2025). A lien can technically be placed on your property after a judgment, but a forced sale is delayed as long as you maintain homestead status. ProMedica has not been found to pursue aggressive lien or foreclosure strategies against patients.
Related Resources
Need Help with Your ProMedica Bill?
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Start Your Free Case ReviewThis guide is for informational purposes only and does not constitute legal or financial advice. Information is based on publicly available ProMedica financial assistance policies and Ohio state law as of 2026. Eligibility requirements, income thresholds, and application processes may change. Always verify current requirements directly with ProMedica at promedica.org or by calling 1-844-373-0871.