Hospitals in Washington cannot deny patients access to care based on an inability to pay. RCW 70.170 and WAC 246-453 require hospitals to develop charity care policies and procedures to ensure that all patients with family incomes below 200 percent of the federal poverty guidelines (PDF) are able to obtain medically necessary hospital health care free of charge, and patients with family incomes up to 400 percent of the federal poverty guidelines are able to obtain that care at a discount.
To calculate your Federal Poverty Level (FPL) use this FPL calculator.
Federal Poverty Levels
| 2025 Federal Poverty Level | 1 Person Household Income | 2 Person Household Income | 3 Person Household Income | 4 Person Household Income |
|---|---|---|---|---|
| 0 to 100% | Up to $15,650 | Up to $21,150 | Up to $26,650 | Up to $32,150 |
| 101% to 200% | $15,651 to $31,300 | $21,151 to $42,300 | $26,511 to $53,300 | $32,151 to $64,300 |
| 201% to 250% | $31,301 to $39,125 | $42,301 to $52,875 | $53,301 to $66,625 | $64,301 to $80,375 |
| 251% to 300% | $39,126 to $46,950 | $52,876 to $63,450 | $66,626 to $79,950 | $80,376 to $96,450 |
| 301% to 350% | $46,951 to $54,775 | $63,451 to $74,025 | $79,951 to $93,275 | $96,451 to $112,525 |
| 351% to 400% | $54,776 to $62,600 | $74,026 to $84,600 | $93,276 to $106,600 | $112,526 to $128,600 |
Required Charity Care Discounts
| 2025 Federal Poverty Level | Required discounts for care provided on or prior to June, 30, 2022 All Hospitals |
Required discounts for care provided on or after July 1, 2022 Tier 1 Hospitals |
Required discounts for care provided on or after July 1, 2022 Tier 2 Hospitals |
|---|---|---|---|
| 0 to 100% | All out-of-pocket costs to 100% | 100% discount | 100% discount |
| 101% to 200% | Sliding scale discounts | 100% discount | 100% discount |
| 201% to 250% | No mandatory discount | 100% discount | 75% discount |
| 251% to 300% | No mandatory discount | 100% discount | 50% discount |
| 301% to 350% | No mandatory discount | 75% discount | No mandatory discount |
| 351% to 400% | No mandatory discount | 50% discount | No mandatory discount |
Family size: When counting family size include anyone who lives in the same household that is related by birth, marriage, or adoption.
Income: When calculating income use the most recent documents at the time of service or at the time of application. Income from all of those in your household should be counted.
A listing of Tier 1 and 2 hospitals is available (PDF).
- What is charity care?
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Charity care is financial aid to help people pay hospital bills. It can make your care free or reduced cost. Charity care can cover all necessary medical care. It may not cover some hospital-based providers.
For more information on charity care, please see these Charity Care Fact Sheets:
- How to apply for charity care
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- See where you and your family stand on the Federal Poverty Level Guidelines.
- Contact the hospital billing department where you received health care services to request a Charity Care or Financial Assistance application.
- Complete the application.
- Gather all income documentation (see document list below).
- Submit the application and income documentation to the hospital where you received health care services.
- Review your Charity Care award letter received by the hospital.
- If denied, you have 30 days to file an appeal by providing a letter of appeal and/or additional income documentation.
- What documents may I need to submit with my application?
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- W-2 Withholding Statement
- Pay Stubs
- An income tax return from the most recent filed calendar year
- Forms approving or denying eligibility for Medicaid and/or state-funded medical assistance
- Forms approving or denying unemployment compensation
- Written statements from employers or welfare agencies
- How to get information about charity care
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Each hospital's approved charity care policy is available at the link below:
- How to file a charity care complaint
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If you think a hospital is not following its approved charity care policy, has unfairly denied you charity care coverage, or refuses to give you a charity care application, you may file a complaint with the department.
Annual Charity Care Reports
The department publishes an annual report on hospital charity care.
Email CharityCare@doh.wa.gov or call 360-236-4210 with charity care questions.