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 140 health care facilities nationwide are still obligated to provide free or reduced-cost care.
Since 1980, more than $6 billion in uncompensated services have been provided to eligible patients through Hill-Burton.
You are eligible to apply for Hill-Burton free care if your income is at or below the current Federal 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 Poverty Guidelines. Facilities may require you to provide documentation that verifies your eligibility, such as proof of income.
Care at Hill-Burton obligated facilities is not automatically free or reduced-cost. You must apply at the admissions or business office at an 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 collection agency.
Only facility costs are covered, not your private doctors' bills.
Some facilities may use different eligibility standards and procedures. They are identified on the Hill-Burton list of obligated facilities as PFCA, CFCA, UACA and 515. Their programs may be called either a free care, charity care, discounted services, indigent care, etc.
Hill-Burton facilities must post a sign in their admissions and business offices and emergency room that notifies the public that free and reduced-cost care is available. 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.
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. Send complaints to:
Director, Division of Poison Control and Healthcare Facilities
5600 Fishers Lane
Rockville, MD 20857
Our brochure entitled “Free Hospital Care” provides additional information about the Hill-Burton program and instructions for filing an application. It also explains circumstances under which a facility may refuse a request and what is needed to file a complaint, if you feel that you have been unfairly denied free or reduced-cost care. “Frequently Asked Questions” (FAQs) are available on this website that may also address your questions or concerns. If you have other questions or concerns not addressed in the FAQs, please email us at DFCRCOMM@hrsa.gov.
Last Reviewed: March 2017