Providence Health Financial Assistance: Free Care to 300% FPL + Post-Scandal Reforms (2026 Guide)
Providence is a nonprofit Catholic health system operating 51 hospitals across 7 states (WA, OR, CA, AK, MT, TX, NM). Free care is available for patients at or below 300% FPL in California, Oregon, and Washington, with sliding-scale discounts up to 350-400% FPL depending on state. Following a $157.8 million settlement with the Washington Attorney General over aggressive billing practices, Providence now proactively screens every patient for financial assistance eligibility.
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Quick Facts
100% Free Care
0-300% FPL in CA, OR, and WA. Other states vary. Single person: up to ~$47,880/yr qualifies for free care in these states.
Sliding-Scale Discounts
301-400% FPL in most states. In Oregon, 70% discount on charges. In California, 85% discount on charges.
51 Hospitals, 7 States
Washington, Oregon, California, Alaska, Montana, Texas, and New Mexico. Includes Swedish Medical Center and Kadlec Regional.
240-Day Application Window
From your first billing statement. Interest-free payment plans available. No liens on primary residences.
Post-Settlement Reform
After a $157.8M settlement, Providence is now required to proactively screen every patient for financial assistance eligibility. If you were billed between 2018 and 2023 without being screened, you may be owed a refund.
Eligibility by State
Providence operates as a nonprofit 501(c)(3) health system, which means federal law (Section 501(r)) requires them to offer financial assistance. However, the specific income thresholds and discount levels vary by state because of differing state charity care laws.
California
- Free care: 0-300% FPL (100% charity care write-off)
- Discounted care: 301-400% FPL (85% discount off original charges)
- Never charged more than Amounts Generally Billed (AGB) to insured patients
Oregon
- Free care: 0-300% FPL (100% charity care write-off)
- Discounted care: 301-400% FPL (70% discount off original charges)
- Eligibility determination within 30 days of complete application
Washington
- Free care: 0-300% FPL (Washington state law requires this for large hospitals)
- Discounted care: May be available above 300% FPL depending on facility
- Eligibility determination within 14 days of complete application
- Assets not considered for households under 300% FPL
- Includes Swedish Medical Center and Kadlec Regional Medical Center
Montana, Alaska, Texas, New Mexico
- Free care: Generally 0-200% to 0-250% FPL (varies by facility)
- Discounted care: Sliding scale up to 300-400% FPL
- Contact your specific Providence facility for exact thresholds
Important Notes
- Both insured and uninsured patients may qualify for financial assistance.
- Covers emergency and medically necessary services only (not elective, cosmetic, or experimental).
- Enrollment in state programs like SNAP, TANF, WIC, CHIP, or free lunch programs may serve as proof of income eligibility.
- Providence will never charge FA-eligible patients more than Amounts Generally Billed (AGB) to insured patients.
Income Guidelines (2026 Federal Poverty Level)
| Income Level (% FPL) | Approx. Income (Single) | CA / OR / WA Benefit |
|---|---|---|
| 0-200% FPL | Up to ~$31,920/yr | 100% Free Care (all 3 states) |
| 201-300% FPL | ~$31,921 - ~$47,880/yr | 100% Free Care (CA, OR, WA) |
| 301-400% FPL | ~$47,881 - ~$63,840/yr | CA: 85% discount, OR: 70% discount |
| Above 400% FPL | Above ~$63,840/yr | Not eligible (payment plans available) |
Income thresholds for AK, MT, TX, and NM may differ. Contact your local Providence facility for specifics.
How to Apply (Step by Step)
Check Your Eligibility
Free care at 0-300% FPL in CA, OR, and WA. Discounted care up to 400% FPL. Other states vary. Use the FPL table above to estimate your household's percentage. Enrollment in SNAP, TANF, WIC, or similar programs may automatically qualify you.
Gather Your Documents
You will need proof of income (pay stubs, tax returns, benefit letters), proof of residency, insurance information (if applicable), and a government-issued photo ID. Providence may also accept enrollment in public assistance programs as proof of income.
Submit Your Application
You can apply through any of these channels:
- Online: providence.org/financialhelp
- Phone: Call 866-747-2455
- In person: Visit Financial Counseling at any Providence hospital
- Mail: Download the application from the website and mail to the address on the form
Wait for a Decision
Providence will notify you in writing of the eligibility determination. Processing times: 14 days in Washington, up to 30 days in other states. Collection activity should be paused while your application is under review.
Follow Up
Call 866-747-2455 to confirm receipt and check status. Keep copies of everything you submit. If approved, the discount or write-off will be applied to your account retroactively.
The McKinsey "Rev-Up" Scandal and What Changed
What Happened
In 2018, Providence hired McKinsey & Company to implement a program called "Rev-Up," designed to increase revenue collected directly from patients. Under this program, emergency department staff were trained to ask every patient for payment upfront, regardless of income, using the motto "Ask Every Patient Every Time."
Multiple former employees reported they were told not to mention the financial assistance that state and federal law required Providence to provide. Training materials instructed staff to tell patients, no matter how poor, that "payment is expected." Patients who qualified for free or discounted care were instead billed in full and, in many cases, sent to debt collectors.
A New York Times investigation in September 2022 brought these practices to national attention, followed by lawsuits from multiple state attorneys general.
The Settlements
Washington State (February 2024): $157.8 million settlement with Attorney General Bob Ferguson. Providence was required to forgive $137.2 million in medical debt for 65,217 patients and refund $20.6 million (with interest) to 34,229 patients. In total, 99,446 individuals were affected.
Oregon: The Oregon Department of Justice opened its own investigation into whether similar practices occurred at Providence facilities in Oregon. Providence also faced scrutiny from state regulators.
Debt Collector (Harris & Harris): Providence's debt collector, Harris & Harris, separately paid $1 million for failing to inform patients of their medical debt collection rights.
What Changed (Post-Settlement Reforms)
- Proactive screening: Providence is now required to screen every patient for financial assistance eligibility, rather than waiting for patients to ask.
- No upfront collection pressure: Staff can no longer pressure patients for payment in emergency settings before determining financial assistance eligibility.
- Debt forgiveness: Qualifying patients who were improperly billed between 2018 and 2023 received automatic refunds or debt relief.
- Expanded outreach: Providence must proactively notify patients about available financial assistance programs.
- Monitoring and compliance: The Washington AG's office continues to monitor Providence's compliance with the settlement terms.
Were you billed by Providence between 2018 and 2023? If you believe you qualified for financial assistance but were billed in full, you may still be entitled to a refund or debt forgiveness. Contact Providence at 866-747-2455 or consult with a patient advocate.
Payment Plans
If you do not qualify for full charity care, or if you have a remaining balance after a partial discount, Providence offers payment options.
Interest-Free Payment Plans
Providence offers interest-free monthly payment plans. The length and monthly amount depend on your balance and financial situation.
No Liens on Primary Residences
Providence does not place liens on patients' primary residences to collect medical debt.
To set up a payment plan, call 866-747-2455 or visit providence.org/billing-support.
Important Warnings and Tips
- 1.Apply within 240 days of your first billing statement. Do not wait. Even if your bill has already gone to collections, you may still be eligible if within this window.
- 2.Do not pay under pressure. After the Rev-Up scandal, Providence reformed its practices, but you should still know your rights. You cannot be required to pay before being screened for financial assistance at a nonprofit hospital.
- 3.Request an itemized bill. Before paying any balance, request a detailed itemized bill and review it for errors, duplicate charges, or services you did not receive.
- 4.Know which state's policy applies. Financial assistance thresholds vary significantly by state. Confirm the specific policy for the Providence facility where you received care.
- 5.Public assistance enrollment counts. If you are enrolled in SNAP, TANF, WIC, CHIP, free school lunch, or low-income energy assistance programs, Providence may accept that as proof of income eligibility without additional documentation.
- 6.Check for Medicaid eligibility first. If you are uninsured, Providence may require you to apply for Medicaid or other government programs before processing your financial assistance application.
- 7.Keep copies of everything. Document all phone calls (date, time, name of representative) and keep copies of your application and all supporting documents.
Need Help With a Providence Bill?
If your financial assistance application was denied, you were billed during the Rev-Up era, or you need help negotiating with Providence, CareRoute Bill Defense can review your case and advocate on your behalf at no upfront cost.
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Plus dozens more hospitals and clinics across 7 states. Visit providence.org for a full list.
Frequently Asked Questions
Who qualifies for Providence financial assistance?
Eligibility varies by state. In California, Oregon, and Washington, patients with household income at or below 300% FPL qualify for 100% free care. Sliding-scale discounts are available up to 400% FPL. In other states (AK, MT, TX, NM), thresholds may differ. Both insured and uninsured patients may apply.
What was the Providence billing scandal?
In 2018, Providence implemented McKinsey's "Rev-Up" program, which trained staff to collect payments from emergency patients without screening them for financial assistance. A 2022 New York Times investigation and subsequent state AG lawsuits led to a $157.8 million Washington settlement in 2024 covering 99,446 affected patients. Providence has since reformed its screening and billing practices.
Can I still get a refund from the scandal period (2018-2023)?
If you were a Washington state patient who was billed without being properly screened for financial assistance between 2018 and 2023, you may have already received an automatic refund or debt forgiveness as part of the settlement. If you believe you were missed, contact Providence at 866-747-2455 or the Washington Attorney General's office.
Does Providence cover insured patients?
Yes. Both insured and uninsured patients may qualify for financial assistance. Insured patients can receive help with out-of-pocket costs such as deductibles, copays, and coinsurance after insurance pays its portion.
How long do I have to apply?
You have 240 days from the date of your first billing statement to submit a complete application. Providence cannot initiate extraordinary collection actions while your application is pending.
Does Swedish Medical Center have the same financial assistance policy?
Yes. Swedish Medical Center in Seattle is owned by Providence and is covered by Providence's Washington state financial assistance policy. It was also included in the $157.8 million settlement. Apply through the same process using Providence's application.
Need Help with Your Providence Bill?
CareRoute Bill Defense can review your medical bills, identify savings opportunities, and negotiate with Providence on your behalf. Whether you need help applying for financial assistance, disputing charges, or dealing with collections, we can help. No upfront cost.
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 Providence Health financial assistance policies and settlement documents as of 2026. Eligibility requirements, income thresholds, and application processes may change and vary by state and facility. Always verify current requirements directly with Providence at 866-747-2455 or visit providence.org.