1. An itemized bill
An itemized bill lists each charge separately, usually with the date, a billing code, a quantity, and a price.
- State law varies. Some states require hospitals to give an itemized bill on request and set a deadline; others do not. Most hospitals will provide one when asked.
- Under federal health privacy rules, you have a right to access your own health information, including billing records. A provider generally must respond within 30 days, with one possible 30-day extension.
- If you're handling a family member's bill, the hospital may need their signed permission form or proof that you are their legal representative.
2. Charity care and financial assistance
Many hospitals offer free or discounted care based on income. The rules depend on the type of hospital and your state.
- Nonprofit hospitals (tax-exempt under IRS Section 501(c)(3)) must have a written financial assistance policy under Section 501(r) of the tax code. They must make it widely available, including on their website and with a plain-language summary.
- For patients who qualify, nonprofit hospitals may not charge more for emergency or other medically necessary care than the amounts generally billed to people with insurance.
- Nonprofit hospitals must accept financial assistance applications for at least 240 days after the first billing statement following discharge, and must make reasonable efforts to check eligibility before taking certain collection actions, such as reporting to credit bureaus.
- Some states have their own charity care laws that also apply to for-profit hospitals. For-profit hospitals may also have voluntary programs — ask.
- You can apply even after you receive a bill, and even if you have insurance.
3. No Surprises Act: Good Faith Estimate dispute
This applies if you are uninsured, or self-pay (you chose not to use insurance).
- Providers and facilities must give you a Good Faith Estimate of expected charges for scheduled care when you schedule it (at least 3 business days ahead in most cases), or when you ask for one.
- If your final bill from any one provider or facility is at least $400 more than its Good Faith Estimate, you can start a patient-provider dispute through the federal government.
- You must start the dispute within 120 calendar days of the date on the original bill. There is a small administrative fee.
- Keep a copy of your Good Faith Estimate and your bill. Learn more at cms.gov/nosurprises or call the No Surprises Help Desk at 1-800-985-3059.
If you have insurance
The No Surprises Act also protects insured patients from most surprise out-of-network bills for emergency care, and for certain care from out-of-network providers at in-network hospitals. In those cases you generally owe only your in-network cost-sharing.
Where to get help
- The hospital's billing office and financial counselors.
- Your insurer, using the number on your insurance card.
- Your state's insurance department or attorney general's consumer protection office.
This page is general information, not legal or insurance advice. Last reviewed October 2026.