Quick Answer: MD Anderson's Patient Financial Assistance Program provides free care for Texas residents earning at or below 200% of the federal poverty level, and sliding-scale discounts up to 400% FPL. Out-of-state patients do not qualify for the core charity care program, but several other financial relief paths are available.
Every year, thousands of cancer patients travel to Houston for care at UT MD Anderson Cancer Center. For many, the bill that follows is as frightening as the diagnosis. MD Anderson provided an estimated $353.8 million in uncompensated care in fiscal year 2024 alone. The question most patients and families ask is: can I get help paying, and does it matter that I live in another state?
This guide walks through exactly how the Financial Assistance Program (FAP) works as of 2026, who meets the eligibility criteria, what documents you need, and what realistic options exist for patients who come from outside Texas.
What Is MD Anderson's Financial Assistance Program?
UT MD Anderson Cancer Center is a nonprofit academic institution within the University of Texas System. Under IRS 501(r) rules, it is required to maintain a written financial assistance policy and to offer charity care to patients who cannot afford their bills.
The program has two tiers:
- Full charity care (100% discount): for patients at or below 200% of the federal poverty level (FPL)
- Partial sliding-scale discount: for patients between 201% and 400% FPL
Patients above 400% FPL are not eligible for the formal charity care program, though they may still negotiate payment plans or seek other assistance described below.
The program covers MD Anderson facility charges, including radiation therapy, infusion services, imaging, and one-time facility fees. Professional fees billed separately by physicians may have different coverage.
Income Limits by Household Size (2026 FPL)
The thresholds below are based on the 2026 federal poverty guidelines published by HHS in January 2026. These apply to the 48 contiguous states including Texas.
| Household Size | 100% FPL | 200% FPL (Full Free Care) | 400% FPL (Max Sliding Discount) |
|---|
| 1 | $15,960 | $31,920 | $63,840 |
| 2 | $21,640 | $43,280 | $86,560 |
| 3 | $27,320 | $54,640 | $109,280 |
| 4 | $33,000 | $66,000 | $132,000 |
| 5 | $38,680 | $77,360 | $154,720 |
| 6 | $44,360 | $88,720 | $177,440 |
| 7 | $50,040 | $100,080 | $200,160 |
| 8 | $55,720 | $111,440 | $222,880 |
| Each additional | +$5,680 | +$11,360 | +$22,720 |
If your gross household income falls at or below the 200% FPL column for your household size, you are potentially eligible for a full write-off of MD Anderson facility charges. Between 200% and 400% FPL, MD Anderson uses a sliding scale: the closer you are to the 200% threshold, the larger the discount.
Before you compare your income to these figures, use the CoveredUSA Bill Analyzer to break down exactly what each charge on your MD Anderson bill represents. Knowing which line items are eligible for financial assistance versus which are physician group charges billed separately prevents surprises after you submit your FAP application.
The Texas Residency Requirement Explained
This is the most important limitation for patients coming from other states.
MD Anderson's Patient Financial Assistance Program requires proof that your primary residence has been in Texas for at least the past six continuous months. The program is funded in part through the state of Texas, which is why the residency gate exists.
Acceptable proof of six months of Texas residency (any one of the following):
- Deed or recent property tax statement with a Texas address
- Notarized letter from a Texas employer on company letterhead showing dates and location of employment
- Bank statements with a Texas address covering the six most recent months
- SNAP or other state benefit statement with a Texas address
- Utility bills in your name with a Texas address (electric, natural gas, water, cable)
- Enrollment records from a Texas public or private school or university
If you do not yet have six months of Texas residency, you will not qualify for the core FAP regardless of your income. This is a hard cutoff in the program rules, not something that can be waived by a financial counselor.
Citizenship and Immigration Status Requirements
In addition to Texas residency, the program requires one of the following:
- U.S. citizenship
- Lawful permanent residency held for at least five years
- Certain qualifying immigrant status as defined by federal benefit eligibility rules
Undocumented patients and those with less than five years of LPR status generally do not qualify for the formal program, though emergency care exceptions and other funds may be available in some circumstances.
What Out-of-State Patients Can Actually Do
If you live outside Texas, the charity care program is off the table. But "no charity care" does not mean "no help." Here are the realistic options in 2026.
1. Negotiate a Payment Plan
MD Anderson's Financial Clearance Center (713-792-4322 or 844-294-4322) works with patients who cannot pay in full but do not meet FAP criteria. A financial specialist can structure an extended payment plan based on what you can realistically pay each month. There is no formal income requirement to request a payment plan.
2. Review Your Bill for Errors
Cancer treatment bills are among the most error-prone in the entire healthcare system. Duplicate charges, miscoded procedures, unbundled services, and charges for services never rendered are common. Before you negotiate anything, audit the bill line by line.
The CoveredUSA Bill Analyzer compares each charge on your MD Anderson bill against Medicare's published reimbursement rates, flags items that look inflated or incorrectly coded, and generates a summary you can bring to the billing department. Overcharges on a single inpatient cancer stay can run tens of thousands of dollars. Upload your hospital bill to the free CoveredUSA Bill Analyzer to find errors, overcharges, and charity care options in 30 seconds.
3. Check Your Home State's Medicaid Coverage at MD Anderson
MD Anderson does not accept traditional out-of-state Medicaid or managed Medicaid plans. However, patients enrolled in certain out-of-network plans that include out-of-network benefits may receive partial coverage. Check your specific plan documents and call the Financial Clearance Center to verify whether your plan is accepted before your first appointment.
4. Apply for External Cancer Financial Assistance Programs
Several national nonprofits provide direct financial grants to cancer patients regardless of where treatment occurs:
- CancerCare: Provides up to $1,000 in direct financial assistance for treatment-related costs, no residency requirement
- Patient Advocate Foundation: Manages a Co-Pay Relief fund and helps with medical debt negotiations
- Leukemia and Lymphoma Society: Disease-specific financial assistance for blood cancer patients
- PAN Foundation: Covers Medicare cost-sharing for patients with specific diagnoses
- NeedyMeds: Database of disease-specific charitable funds and drug assistance programs
These programs are separate from MD Anderson's internal FAP. Applying to both (if you qualify for FAP) or to the external programs alone (if you do not) is a common strategy.
5. Establish Texas Residency (If Applicable)
For patients who expect to be in Houston for extended treatment (which is common at a destination cancer center), it may be worth asking a social worker at MD Anderson whether establishing Texas residency during treatment would eventually open the door to the FAP. This is a situation-specific question that depends on your treatment timeline and personal circumstances.
How to Apply for MD Anderson Financial Assistance (Texas Residents)
If you meet the Texas residency and citizenship requirements, here is the step-by-step application process.
Step 1: Request an application. Contact your patient access representative or financial clearance representative at your first appointment, or call the Financial Clearance Center at 713-792-4322. You can also request the application online through MD Anderson's financial assistance page.
Step 2: Gather income documentation. Collect the most recent federal tax return (Form 1040), the two most recent pay stubs for all household members who work, and documentation of any Social Security, pension, or other income. If you are self-employed, three months of recent bank statements are typically required.
Step 3: Gather residency documentation. As described above, any single document proving six months of continuous Texas residency works.
Step 4: Gather identity and status documents. A government-issued photo ID and either proof of U.S. citizenship (passport, birth certificate) or permanent resident card are required.
Step 5: Submit the complete application. Incomplete applications are the most common cause of delays. Double-check that all supporting documents are included before submitting.
Step 6: Wait for a determination. MD Anderson typically processes financial assistance applications within 30 days. During this time, your account may be placed on hold while the review is pending.
Step 7: Appeal if denied. If you are denied and believe there was an error (such as an incorrect income calculation or a document that was missed), you have the right to request a review. Contact the financial assistance office directly to initiate an appeal.
How MD Anderson FAP Compares to Other Cancer Center Financial Assistance Programs
For patients who may be considering other nationally recognized cancer centers, the residency requirement is not universal. Below is a general comparison as of 2026.
| Cancer Center | Full Free Care Threshold | Residency Requirement |
|---|
| MD Anderson (Houston, TX) | Up to 200% FPL | Texas residents only |
| Memorial Sloan Kettering (New York, NY) | Up to 200% FPL | No state residency requirement |
| Mayo Clinic (Rochester, MN) | Varies by facility | No state residency requirement |
| Cleveland Clinic (Cleveland, OH) | Up to 200% FPL | No state residency requirement |
| Johns Hopkins (Baltimore, MD) | Up to 200% FPL | No state residency requirement |
If you are choosing a cancer center partly based on financial assistance access, this comparison matters. MD Anderson's clinical quality is well established, but the residency restriction means out-of-state patients may receive more financial relief at comparable institutions.
Key Phone Numbers and Contacts
- Financial Clearance Center: 713-792-4322 or toll-free 844-294-4322 (Monday through Friday, 8 a.m. to 6 p.m. Central)
- Patient Billing: 713-792-2991 or toll-free 1-800-527-2318
- General Patient Assistance Line: 1-877-632-6789
- Social Work Department: Ask for a financial social worker at your first appointment
Frequently Asked Questions
Does MD Anderson offer financial assistance to uninsured patients from other states?
The formal Patient Financial Assistance Program requires Texas residency, so out-of-state uninsured patients do not qualify for the charity care program itself. However, uninsured out-of-state patients can still request payment plans, apply to external cancer financial assistance nonprofits, and ask a social worker at MD Anderson to help identify other resources.
What is the income cutoff for free care at MD Anderson in 2026?
For Texas residents, full free care covers patients at or below 200% of the 2026 federal poverty level. That is $31,920 for a single person, $43,280 for a household of two, $54,640 for three people, and $66,000 for a household of four.
Can I apply for MD Anderson financial assistance before my treatment starts?
Yes. MD Anderson encourages patients to start the financial assistance review before or at the time of their first appointment, not after they have already received a bill. Applying proactively reduces stress and avoids collection activity while your account is under review.
What happens to my bill while the financial assistance application is being reviewed?
MD Anderson typically places your account on hold while a financial assistance application is pending. This means collection activity is paused during the review period. Confirm this directly with the billing office when you submit your application.
Do I need to reapply for financial assistance if I return for multiple treatment phases?
Generally, yes. Financial assistance determinations are tied to specific billing periods and typically need to be renewed. If your income or household situation changes significantly, a new application may produce a different result.
I already got a bill from MD Anderson. Can I still apply retroactively?
Yes. You can apply for financial assistance on bills that have already been issued. The program can potentially apply retroactively to recent charges. Contact the Financial Clearance Center as soon as possible, do not wait until you are in collections.
What if I can't afford MD Anderson at all and need to find treatment closer to home?
If cost is a significant barrier, the National Cancer Institute maintains a directory of NCI-designated cancer centers across all 50 states. Many of these centers have their own financial assistance programs without residency restrictions. Your state Medicaid program (if you qualify) will also cover cancer treatment at in-network facilities.
How do I know if charges on my MD Anderson bill are correct?
Hospital billing errors are common, especially for complex cancer treatment with multiple service lines billed separately. Upload your bill to the CoveredUSA Bill Analyzer to compare your charges against benchmarks, identify potential errors, and understand what you are actually being billed for before you pay or negotiate.
