UNC Health Financial Assistance: Free Care at 250% FPL + Discounts to 400% FPL (2026 Guide)
UNC Health Care System (UNCHCS) offers 100% free care for North Carolina residents with household income at or below 250% of the Federal Poverty Level, sliding-scale discounts for those between 251-400% FPL, and an automatic 40% discount for all uninsured patients. The policy covers UNC Hospitals in Chapel Hill, UNC Children's Hospital, Rex Hospital in Raleigh, and more than a dozen regional facilities across the state. As North Carolina's flagship public academic medical center, UNC Health provided over $400 million in uncompensated care in its most recent fiscal year.
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Quick Facts
100% Free Care
Household income at 0-250% FPL (single: up to ~$39,900/yr) qualifies for full charity care covering all medically necessary services
Sliding Scale to 400% FPL
Income between 251-400% FPL (~$39,901 to ~$63,840/yr single) receives percentage-based discounts on a sliding fee schedule
40% Uninsured Discount
All uninsured patients (or those without access to U.S. medical insurance) automatically receive a 40% discount on charges, regardless of income
No Wage Garnishment in NC
North Carolina law prohibits wage garnishment for medical debt. UNC Health does not pursue lawsuits against patients.
State-Supported Public System
UNC Health is the state's public academic medical system, affiliated with the University of North Carolina. As a tax-exempt nonprofit with a state mission, UNC Health is obligated to provide meaningful charity care to qualifying residents of North Carolina.
Eligibility & Income Limits (2026 Federal Poverty Guidelines)
| Income Level (% FPL) | Approximate Income (Single) | Discount Level |
|---|---|---|
| 0-250% FPL | Up to ~$39,900/yr | 100% Free Care |
| 251-400% FPL | ~$39,901 - ~$63,840/yr | Sliding-scale discount (percentage based on income and household size) |
| Uninsured (any income) | Any income level | Automatic 40% discount on all charges |
| Above 400% FPL | Above ~$63,840/yr | May qualify for payment plans or hardship review on a case-by-case basis |
Important Notes
- Both insured and uninsured patients may qualify for income-based financial assistance.
- NC residency required: Applicants must be residents of North Carolina. Assets are also considered in the eligibility determination.
- Uninsured discount stacks: Uninsured patients receive the 40% discount automatically, and can then apply for additional income-based assistance on the remaining balance.
- NC Medicaid covers adults up to 138% FPL since the state expanded Medicaid in December 2023.
- UNC Health will never charge FA-eligible patients more than Amounts Generally Billed (AGB) to insured patients.
- Medically necessary services are covered, including inpatient, outpatient, and emergency care.
North Carolina Context: Medicaid Expansion and $6.5B Debt Relief
NC Medical Debt Relief Program
As of October 2025, North Carolina has erased more than $6.5 billion in medical debt for over 2.5 million residents through the state's Medical Debt Relief Program. This is tied to the Healthcare Access and Stabilization Program (HASP), which began alongside Medicaid expansion.
Who Benefits from NC Debt Relief?
- Medicaid enrollees (enrolled as of July 1, 2025): All outstanding medical debt dating back to January 1, 2014 owed to participating hospitals is relieved
- Non-Medicaid patients at or below 350% FPL: Medical debt more than two years old (dating back to January 1, 2014) owed to participating hospitals is relieved
- Patients whose total medical debt exceeds 5% of income: Also eligible for debt relief on qualifying balances
- Every eligible hospital in North Carolina signed on to participate, including all UNC Health facilities
NC Medicaid Expansion (December 2023)
North Carolina expanded Medicaid in December 2023, covering adults with income up to 138% FPL (~$22,024/yr single). If you are uninsured and earn below this threshold, apply for NC Medicaid first. If approved, Medicaid will cover your UNC Health bills directly. UNC Health requires uninsured patients to cooperate with Medicaid screening as part of the financial assistance process.
Check both programs: You may benefit from NC's medical debt relief program for older balances AND UNC Health's financial assistance policy for current or recent bills. These programs work independently, so qualifying for one does not disqualify you from the other.
UNC Health Hospitals and Facilities
Major Hospitals
Regional Hospitals
Physician Practices
The UNCHCS Financial Assistance Policy applies to all UNC Health Care System entities listed above. Some independently billing providers may have separate policies. Always confirm coverage when scheduling. UNC Health's official website maintains a complete list of covered and non-covered providers.
Documents You Will Need
Income Verification
- Most recent federal tax return
- Recent pay stubs (most recent 30 days)
- Benefit letters (Social Security, disability, unemployment)
- Self-employment income documentation
- Income for all household members
Other Documentation
- Government-issued photo ID
- Proof of North Carolina residency
- Bank statements (checking and savings)
- Insurance information (if applicable)
- Completed UNC Health Financial Assistance Application
Important: UNC Health considers both income and assets when determining eligibility. Incomplete applications can delay or prevent approval. Make sure every required field is filled out and all supporting documents are included before submitting.
How to Apply (Step by Step)
Check Your Eligibility
100% free care at 0-250% FPL (~$39,900/yr single). Sliding-scale discounts at 251-400% FPL (~$63,840/yr single). Automatic 40% discount for uninsured patients at any income level.
Contact UNC Health Financial Assistance
Call 866-704-5286 (toll-free) or 984-974-3425 (local). Hours: Monday through Thursday 8:30 AM to 4:30 PM, Friday 8:30 AM to 12:30 PM. A Financial Navigator can walk you through the process and help determine which programs you qualify for.
Complete the Application
Download the UNC Health Financial Assistance Application from unchealth.org or request one by phone. Fill out completely with household income, family size, and residency information. Financial Navigators are available in person at UNC Health facilities to help you complete the form.
Submit Your Application
You can submit by:
- My UNC Chart: Submit securely through the patient portal
- Secure Fax: 984-974-6425
- Mail: UNC Health Financial Assistance, 500 Eastowne Drive, Suite 160, Chapel Hill, NC 27514
- In Person: Financial Navigators at any UNC Health facility
Follow Up
Call 866-704-5286 or 984-974-3425 to confirm receipt and check status. Determination is typically made within 30 days of receiving a complete application. Keep copies of everything you submit.
Common Pitfalls to Avoid
- Missing documentation: Bank statements and tax returns are required. Missing these will delay your application significantly.
- Skipping Medicaid screening: Uninsured patients must cooperate with Medicaid or government assistance screening before FA eligibility is determined.
- Not including all household members: All income and household members must be reported for accurate FPL calculation.
- Waiting too long: Apply as soon as you receive your bill. Do not wait until the account goes to collections.
- Forgetting the uninsured discount: If you lack insurance, the 40% discount should be applied automatically. If it is not on your bill, call and request it.
Struggling with a UNC Health Bill?
CareRoute Bill Defense can review your UNC Health bill for errors, identify financial assistance you may be missing, and negotiate directly with UNC Health on your behalf. No upfront cost.
Get Help with Your UNC Health BillPayment Plans
Interest-Free Payment Plans
- Available to patients who do not qualify for full charity care
- No interest charged on payment arrangements
- Monthly payment amounts based on ability to pay
- Set up through My UNC Chart or by calling Financial Assistance
- Plans can be adjusted if your financial situation changes
How to Set Up a Payment Plan
- Call 866-704-5286 (toll-free) or 984-974-3425 (local)
- Set up online through My UNC Chart patient portal
- Speak with a Financial Navigator in person at any UNC Health facility
- Request a plan before your account is sent to collections
Collection Practices: What to Know
The Good News
- North Carolina prohibits wage garnishment for medical debt
- UNC Health does not pursue lawsuits against patients for medical bills
- As a state-affiliated institution, UNC Health has stronger patient protections than private hospitals
- The NC Medical Debt Relief Program may eliminate older qualifying debt automatically
What Still Happens
- UNC Health will send multiple billing statements and contact attempts
- If the balance remains unresolved, the account may be placed with a collection agency
- Collection agencies may contact you to resolve the balance
- Medical debt may still appear on credit reports (though federal rules now exclude medical debt under $500 and debt less than one year old)
Apply for financial assistance as soon as possible. Do not ignore bills, even though NC has strong patient protections.
What If You Are Denied?
1. Ask Why and Reapply
Call 866-704-5286 or 984-974-3425 to learn the specific reason for denial. Common reasons include income above 400% FPL, incomplete documentation, assets above the threshold, or missing NC residency proof. You can reapply with corrected or additional documentation.
2. Request the Uninsured Discount
If you are uninsured and were denied income-based assistance, you should still receive the automatic 40% uninsured discount. This is separate from the income-based program. If it was not applied to your bill, call and request it explicitly.
3. Explore Other Options
- NC Medicaid: Covers adults up to 138% FPL since December 2023 expansion
- NC Medical Debt Relief: Check if your older debt qualifies under the state program
- Payment plans: Interest-free options available for all patients
- Request an itemized bill: Review all charges for errors or duplicate billing
- Dollar For: Nonprofit that helps patients apply for charity care (dollarfor.org)
- NC state rights: Review your North Carolina medical billing rights
Let CareRoute Bill Defense Help
If your application was denied or you need help negotiating your UNC Health 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
Mon-Thu: 8:30 AM - 4:30 PM | Fri: 8:30 AM - 12:30 PM
Fax, Mail & Online
Frequently Asked Questions
Who qualifies for UNC Health financial assistance?
North Carolina residents with household income at or below 250% FPL (~$39,900/yr single) qualify for 100% free care. Those between 251-400% FPL get sliding-scale discounts. Uninsured patients automatically receive a 40% discount on all charges regardless of income. Both insured and uninsured patients can apply for income-based assistance.
Does UNC Health garnish wages or sue patients?
No. North Carolina law prohibits wage garnishment for medical debt. UNC Health, as a state-affiliated nonprofit system, does not pursue lawsuits against patients for medical bills. However, unpaid accounts may still be placed with collection agencies if left unresolved.
What is the uninsured discount?
UNC Health provides an automatic 40% discount on all charges for patients who are uninsured or do not have access to U.S. medical insurance. This applies regardless of income level. You can also apply for additional income-based assistance on the remaining balance after the uninsured discount is applied.
Which UNC Health facilities are covered?
The UNCHCS Financial Assistance Policy covers all system hospitals including UNC Hospitals (Chapel Hill), UNC Children's, Rex Hospital (Raleigh), Johnston Health, Nash UNC Health Care, Wayne UNC Health Care, Chatham Hospital, UNC Health Blue Ridge, UNC Health Southeastern, UNC Health Appalachian, UNC Lenoir, Pardee Hospital, Caldwell Memorial, UNC Rockingham, and UNC Physicians Network practices.
Can I get help with my UNC Health bill if I have insurance?
Yes. Both insured and uninsured patients may qualify for financial assistance. Insured patients can receive help with out-of-pocket costs including deductibles, copays, and coinsurance after insurance has paid its portion. Your household income relative to the FPL determines eligibility.
What about North Carolina's medical debt relief program?
NC has erased over $6.5 billion in medical debt since 2024. Medicaid enrollees can have all hospital debt dating back to January 1, 2014 relieved. Non-Medicaid patients at or below 350% FPL (or those whose debt exceeds 5% of income) can have debt more than two years old relieved. This is separate from UNC Health's own financial assistance policy, and you may benefit from both.
Related Resources
Need Help with Your UNC Health Bill?
CareRoute Bill Defense can review your medical bills, identify savings opportunities, and negotiate with UNC Health on your behalf. 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 UNC Health Care System financial assistance policies as of 2024-2025. Eligibility requirements, income thresholds, and application processes may change. Always verify current requirements directly with UNC Health at 866-704-5286 or 984-974-3425, or visit unchealth.org.