In 1946, Congress passed a law that gave hospitals,
nursing homes and other health facilities grants and
loans for construction and modernization. In return,
they agreed to provide a reasonable volume of services
to persons unable to pay and to make their services
available to all persons residing in the facility’s
area. The program stopped providing funds in 1997, but
about 200 health care facilities nationwide are still
obligated to provide free or reduced-cost care.
Steps to Apply for Hill-Burton Free or reduced-cost
- Find the Hill-Burton obligated facility nearest
you from the list
of Hill-Burton obligated facilities.
- Go to the facility's admissions or business office
and ask for a copy of the Hill-Burton Individual
Notice. The Individual Notice will
tell you what income level makes you eligible for
free or reduced-cost care, what services might be
covered, and exactly where in the facility to apply.
- Go to the office listed in the Individual
Notice and say you want to apply for Hill-Burton
free or reduced-cost care. You may need to fill
out a form.
- Gather any other required documents (such as
a pay stub to prove income eligibility) and take
or send them to the obligated facility.
- If you are asked to apply for Medicaid, Medicare,
or some other financial assistance program, you
must do so.
- When you return the completed application, ask
for a Determination of Eligibility. Check
the Individual Notice to see how much time
the facility has before it must tell you whether
or not you will receive free or reduced-cost care.
More about Hill-Burton Free or Reduced-Cost Care
You are eligible to apply for Hill-Burton free care
if your income is at or below the current HHS Poverty
Guidelines. You may be eligible for Hill-Burton reduced-cost
care if your income is as much as two times (triple
for nursing home care) the HHS
Care at a Hill-Burton obligated facility is not automatically
free or reduced-cost. You must apply at the admissions
or business office at the obligated facility and be
found eligible to receive free or reduced-cost care.
You may apply before or after you receive care --
you may even apply after a bill has been sent to a
Some Hill-Burton facilities may use different eligibility
standards and procedures.
Hill-Burton facilities must post a sign in their
admissions and business offices and emergency room
that says: NOTICE - Medical Care for Those Who
Cannot Afford to Pay, and they must provide you
with a written Individual Notice that lists
the types of services eligible for Hill-Burton free
or reduced-cost care, what income level qualifies
for free or reduced-cost care and how long the facility
may take in determining an applicant's eligibility.
Only facility costs are covered, not your private
doctors' bills. Facilities may require you to provide
documentation that verifies your eligibility, such
as proof of income.
Hill-Burton facilities must provide a specific amount
of free or reduced cost care each year, but can stop
once they have given that amount. Obligated facilities
publish an Allocation Plan in the local newspaper
each year. The Allocation Plan includes the
income criteria and the types of services it intends
to provide at no cost or below cost. It also specifies
the amount of free or reduced cost services it will
provide for the year.
When you apply for Hill-Burton care, the obligated
facility must provide you with a written statement
that tells you what free or reduced-cost care services
you will get or why you have been denied.
The facility may deny your request if
- Your income is more than the income specified
in the Allocation Plan.
- The facility has given out its required amount
of free care as specified in its Allocation
- The services you requested or received are not
covered in the facility's Allocation Plan.
- The services you requested or received are to
be paid by a governmental program such as Medicare/Medicaid
- The facility asked you to apply for Medicare/Medicaid
or other governmental program, and you did not.
- You did not give the facility proof of your income,
such as a pay stub.
You may file a complaint with the U.S. Department
of Health and Human Services if you believe you have
been unfairly denied Hill-Burton free or reduced-cost
care. Your complaint must be in writing and can be
a letter that simply states the facts and dates concerning
the complaint. You may call your local legal aid services
for help in filing a complaint. Send complaints to:
Director, Division of Facilities Compliance and Recovery
5600 Fishers Lane
Rockville, MD 20857
there is no Hill-Burton Obligated
you owe bills or need care,
contact the department of social services
at the hospital where you were or
intend to be treated and your county
department of social services to see
if they can help you.
you need help paying for prescription
medications, see the Partnership
for Patient Assistance (not a
U.S. Government Web site)