If you received a bill from Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, or another Hopkins Medicine facility in Maryland, you may qualify for free or reduced-cost care under the Johns Hopkins Medicine Financial Assistance Program (FAP). As of 2026, Johns Hopkins provides 100% free care to patients at or below 200% of the Federal Poverty Level and discounted care on a sliding scale up to 300% FPL. Maryland's all-payer rate-setting system makes this possible at a scale few other states match.
Quick Answer: Johns Hopkins financial assistance (charity care) in 2026 covers 100% of costs for patients at or below 200% FPL (about $66,000 for a family of four) and provides sliding-scale discounts up to 300% FPL (about $99,000 for a family of four). You have 240 days from your first bill to apply. Call 443-997-3067 or email FinancialAssistance@jhmi.edu to start.
What Is the Johns Hopkins Financial Assistance Program?
The Johns Hopkins Medicine Financial Assistance Program (FAP) is a charity care policy that applies across Johns Hopkins Medicine hospital facilities in Maryland, including The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, and Sibley Memorial Hospital. The program covers medically necessary care and emergency services.
Under Maryland law and the Health Services Cost Review Commission (HSCRC) guidelines, all Maryland hospitals must offer free care to patients at or below 200% FPL and some form of reduced-cost care up to 500% FPL, per regulations updated December 2025. Johns Hopkins meets and in some tiers exceeds these baseline requirements.
The program is not just theoretical. As of 2026, roughly 3.99% of total Maryland hospital revenue is set aside as uncompensated care, built prospectively into hospital rates by the HSCRC. That means charity care costs are distributed across all payers rather than falling entirely on uninsured patients or hospitals alone.
How Maryland's All-Payer System Strengthens Charity Care
Maryland operates the only all-payer hospital rate-setting system in the United States, regulated by the HSCRC under a CMS waiver. Under this model:
- Every insurer, including Medicare, Medicaid, and private plans, pays the same rate for the same hospital service.
- Hospitals receive a global budget that includes a fixed allocation for uncompensated care, so charity care does not threaten hospital finances the way it does in states without rate regulation.
- The AHEAD Model agreement signed November 2024 extends this framework through 2034 with additional cost-of-care targets starting in 2026.
For patients, this matters because Maryland hospitals face stronger incentives to grant charity care applications. A denied application does not help the hospital's bottom line the way it might in a fee-for-service state.
Since December 2025, updated HSCRC regulations also require that financial assistance be available to all eligible Maryland residents regardless of citizenship or immigration status, and mandate a standardized financial assistance form across all Maryland hospitals, the HSCRC Uniform Financial Assistance Application.
Johns Hopkins Charity Care Income Limits for 2026
The income thresholds below use the 2026 Federal Poverty Guidelines published by HHS in January 2026, per aspe.hhs.gov.
Johns Hopkins Maryland FAP Income Limits, 2026
| Household Size | 200% FPL: Free Care | 300% FPL: Discounted Care |
|---|
| 1 | $31,920 | $47,880 |
| 2 | $43,280 | $64,920 |
| 3 | $54,640 | $81,960 |
| 4 | $66,000 | $99,000 |
| 5 | $77,360 | $116,040 |
| 6 | $88,720 | $133,080 |
| 7 | $100,080 | $150,120 |
| 8 | $111,440 | $167,160 |
| Each additional | +$11,360 | +$17,040 |
Free care (100% write-off): Annual income at or below the 200% FPL column above.
Discounted care (sliding scale): Income between the 200% and 300% FPL columns. Discounts range from 35% to 75% off gross charges, applied to the amount above AGB (Average Billed Charges). The exact discount percentage within this tier depends on where your income falls in the range.
Above 300% FPL: Standard financial assistance does not apply, but Johns Hopkins will consider hardship applications for patients experiencing catastrophic medical debt. Contact the financial assistance office directly for evaluation.
If you are unsure whether your bill is accurate before applying, uploading it to the CoveredUSA Bill Analyzer takes under 30 seconds and flags common billing errors, overcharges, and whether your hospital's charity care threshold likely applies to your household.
What Charges Does the Program Cover?
The Johns Hopkins Medicine FAP covers:
- Medically necessary inpatient and outpatient services at participating Johns Hopkins Medicine hospitals
- Emergency services (hospitals cannot require copayments for emergency care under Maryland law)
- Services rendered at the facility even if you were uninsured at the time of service
The FAP does not automatically extend to Johns Hopkins-affiliated physician practices that bill separately. If you received bills from a Johns Hopkins Medicine physician group as well as the hospital, ask specifically whether the physician group participates in the same FAP, as separate applications may be required.
How to Apply for Johns Hopkins Financial Assistance
Maryland law gives you 240 days from your first post-discharge billing statement to apply. Do not wait, as the 240-day window applies even if the account has already moved to collections.
Step-by-Step Application
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Call or email the financial assistance office. Phone: 443-997-3067 (local) or 1-855-662-3017 (toll-free). Hours: Monday through Friday, 8:30 AM to 4:30 PM. Email: FinancialAssistance@jhmi.edu. Request the Financial Assistance Application or download it from hopkinsmedicine.org.
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Complete the application in your language. The Johns Hopkins Medicine Financial Assistance Application is available in English, Spanish, Chinese, Korean, Portuguese, Russian, French, Farsi, Japanese, Tagalog, and Vietnamese.
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Gather your documentation (see checklist below).
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Submit by email, fax, or mail. Email: FinancialAssistance@jhmi.edu. Fax: 443-769-1250. Mail: Johns Hopkins Hospital, 3910 Keswick Road, Suite S-5100, ATTN: Financial Assistance Liaison, Baltimore, MD 21211. Applications are not accepted in person.
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Receive determination. Johns Hopkins typically processes applications within 30 days. If approved, discounts are applied retroactively to the bills covered by the application.
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Appeal if denied. Request a written explanation, submit additional documentation, or contact a patient advocate. You can also contact the Maryland Health Care Commission or the state attorney general's consumer protection division.
Documents Needed
- Government-issued photo ID
- Proof of income: two most recent pay stubs, most recent W-2, or prior year federal tax return (Form 1040 with Schedule C if self-employed)
- If unemployed: written statement from the Office of Unemployment Insurance or equivalent documentation
- Proof of Maryland residence: utility bill, lease agreement, or bank statement dated within 60 days
- Insurance card or written proof of uninsured status
- The medical bill(s) from Johns Hopkins you are requesting assistance for
- If applicable: Social Security award letter, disability documentation, or documentation of other income sources
Common Reasons Applications Get Denied
- Missing or incomplete income documentation (no pay stubs, tax return, or employer letter)
- Income reported inconsistently across months (seasonal workers should document seasonal variation)
- Application submitted after the 240-day window
- Applicant listed additional household members without documentation of their income
- Business income reported without a Schedule C or profit/loss statement
Maryland All-Payer Protection: What Patients Often Don't Know
Under the 2025 HSCRC regulations effective December 11, 2025, Maryland hospitals including Johns Hopkins:
- Cannot deny financial assistance based on citizenship or immigration status
- Cannot sell patient medical debt to third-party debt collectors
- Cannot report unpaid hospital bills to credit bureaus without first offering the patient the opportunity to apply for financial assistance
- Must use the standardized HSCRC Uniform Financial Assistance Application, which is accepted by all Maryland hospitals. If you have already completed the HSCRC form for one Maryland hospital, ask whether a copy can be submitted to Johns Hopkins.
These protections apply at The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, and Sibley Memorial Hospital (Washington, D.C., note: DC charity care rules differ from Maryland).
Is Your Bill Correct Before You Apply?
Before submitting a charity care application, check whether the bill itself is accurate. Maryland hospitals participate in the all-payer rate system, which means charges are standardized, but billing codes and line-item entries still contain errors at rates estimated above 80% of complex hospital bills nationwide.
The CoveredUSA Bill Analyzer compares each line of your Johns Hopkins hospital bill against published Medicare rates, flags duplicate charges, unbundled procedure codes, and itemized charges inconsistent with your diagnosis. Upload your bill at coveredusa.org/medical-bill-analyzer for a free review. A corrected bill can also strengthen a financial assistance application by reducing the gross amount being requested.
How the AHEAD Model Affects Charity Care Through 2034
In November 2024, Maryland and CMS signed the AHEAD Model agreement extending the all-payer framework through 2034. Starting in 2026, the HSCRC must achieve Medicare total cost of care savings of approximately $525 million annually against a 2023 baseline, per CMS.gov.
The implications for patients applying for Johns Hopkins financial assistance in 2026 and beyond:
- Hospital budgets remain globally regulated, keeping uncompensated care allocations stable.
- HSCRC oversight of hospital charity care practices continues and has been recently strengthened (December 2025 regulations).
- The standardized application form is expected to reduce administrative denials across all Maryland hospitals.
- Hospitals that do not meet charity care minimums face HSCRC rate penalties, giving them a direct financial reason to process applications fairly.
Johns Hopkins All Children's Hospital (Florida)
Johns Hopkins All Children's Hospital in St. Petersburg, Florida operates a separate financial assistance program under Florida state law. Income thresholds and documentation requirements differ from the Maryland FAP. If your bill is from the Florida facility, contact the All Children's financial assistance office directly at the number listed on hopkinsmedicine.org/all-childrens-hospital.
Frequently Asked Questions
What income qualifies for free care at Johns Hopkins in 2026?
As of 2026, patients with annual household income at or below 200% of the Federal Poverty Level qualify for 100% free care. For a single person, that is $31,920. For a family of four, it is $66,000. These thresholds are based on the 2026 HHS poverty guidelines published in January 2026 by aspe.hhs.gov.
What if my income is above 200% but below 300% FPL?
You qualify for discounted care on a sliding scale. Discounts range from 35% to 75% off gross charges depending on where your income falls within the 200% to 300% FPL band. For a family of four in 2026, that band runs from $66,001 to $99,000 annually.
Can I apply for financial assistance if my bill is already in collections?
Yes. Maryland law provides 240 days from the first post-discharge billing statement to apply for charity care. This window applies even if the account has been sent to a collections agency. Submit your application immediately and notify the collections agency in writing that you have applied for financial assistance. The HSCRC December 2025 regulations prohibit hospitals from selling debt to collectors without first providing you the opportunity to apply.
Does Johns Hopkins accept the HSCRC Uniform Financial Assistance Application?
Yes. Maryland hospitals including Johns Hopkins are required to accept the standardized HSCRC application effective December 2025. You can find the HSCRC Uniform Financial Assistance Application at hscrc.maryland.gov.
Do I need to be a Maryland resident to qualify?
Johns Hopkins does not restrict financial assistance to Maryland residents. The program covers patients who received care at Johns Hopkins Medicine facilities in Maryland regardless of where they live. However, some documentation requirements may differ for out-of-state patients.
What if I am undocumented?
Per the December 2025 HSCRC regulations, Maryland hospitals including Johns Hopkins cannot deny financial assistance based on citizenship or immigration status. The FAP is available to all eligible patients who meet the income criteria.
How do I know if my Johns Hopkins bill has errors before applying for charity care?
Upload your itemized bill to the CoveredUSA Bill Analyzer for a free review. It compares your charges against Medicare benchmark rates and flags common billing errors. Correcting errors before applying can change the amount your charity care application needs to cover.
Can I get a payment plan if I don't qualify for charity care?
Yes. Johns Hopkins offers payment plans for patients who do not qualify for the FAP or who receive only partial assistance. Ask the financial assistance office for a zero-interest payment plan based on your remaining balance. Under Maryland HSCRC rules, hospitals must offer payment plans to low-income patients up to 500% FPL.
How long does it take to get a decision on a Johns Hopkins FAP application?
Most applications receive a determination within 30 days of submission with complete documentation. If documentation is missing, Johns Hopkins will contact you to request it, which restarts the review clock. Submit a complete package to minimize delay.
