If you have a hospital bill from UPMC, Penn State Health, or another Pennsylvania system, you may owe far less than the statement says, or nothing at all. Pennsylvania's major nonprofit hospitals run charity care programs that wipe out or sharply reduce bills for qualifying patients, yet most people never apply because they don't know the programs exist or assume they won't qualify.
Quick Answer: As of 2026, UPMC provides free care to uninsured patients at or below 300% of the Federal Poverty Level (FPL), roughly $99,000 for a family of four, and discounted care up to 400% FPL. Penn State Health offers free care to patients below 200% FPL and sliding-scale discounts up to 300% FPL. Pennsylvania also exempts all wages from garnishment for medical debt, giving PA residents one of the strongest collection-protection floors in the country.
This guide covers what Pennsylvania hospitals must offer, how UPMC and Penn State Health programs actually work, what new state legislation is changing, and how to dispute or reduce a bill you cannot pay.
Pennsylvania Medical Debt in 2026: What the State Actually Requires
Pennsylvania does not have a statewide charity care law setting minimum income thresholds. It relies primarily on federal 501(c)(3) nonprofit hospital requirements. Under federal law (IRS Section 501(r)), every nonprofit hospital must:
- Maintain a written Financial Assistance Policy (FAP)
- Offer a plain-language summary of the FAP
- Publicize the program widely (signs, billing statements, website)
- Provide emergency care regardless of ability to pay
- Limit charges to patients who qualify for financial assistance to no more than Amounts Generally Billed (AGB), the average paid by Medicare and private insurers for the same services
What Pennsylvania adds on top of federal law is limited but meaningful:
Wage garnishment protection: Pennsylvania exempts 100% of wages from garnishment for consumer debts, including medical debt. A Pennsylvania hospital or debt collector cannot take money from your paycheck. This is one of the strongest wage-exemption rules in any state.
Fair Credit Extension Uniformity Act: Pennsylvania's debt collection law prohibits unfair and deceptive collection practices, including harassment and misrepresentation of what you owe.
Pending legislation (2025-2026): A bill passed the Pennsylvania House in May 2025 with a 187-16 vote. As amended, it focuses on improving access to financial assistance programs rather than directly forgiving debt. As of 2026, the bill is in the Republican-controlled Senate. If passed, it would require hospitals to proactively screen patients for financial assistance eligibility and simplify the application process. Per Spotlight PA, hospitals like UPMC and AHN have opted out of a separate proposed debt relief fund but do offer their own internal programs.
UPMC Charity Care: Income Limits for 2026
UPMC is the dominant hospital system in western Pennsylvania with more than 40 hospitals statewide. Its financial assistance program applies system-wide.
UPMC 2026 Financial Assistance Thresholds
| FPL Bracket | What You Pay |
|---|
| 0% to 300% FPL | 100% forgiven (free care), uninsured patients |
| 301% to 400% FPL | Discounted care (sliding scale) |
| Above 400% FPL | May qualify if out-of-pocket exceeds 15% of gross income |
UPMC applies these thresholds to uninsured patients as a baseline. Insured patients with unaffordable cost-sharing (high deductibles, large copays) can also apply. The hardship review looks at whether your total out-of-pocket liability exceeds 15% of your household income.
UPMC 2026 Dollar Thresholds at 300% FPL (Free Care Cutoff)
Pennsylvania uses the 48-state Federal Poverty Guidelines published January 13, 2026 by HHS ASPE.
| Household Size | 100% FPL (2026) | 300% FPL (UPMC Free Care) | 400% FPL (UPMC Discount Cutoff) |
|---|
| 1 | $15,960 | $47,880 | $63,840 |
| 2 | $21,640 | $64,920 | $86,560 |
| 3 | $27,320 | $81,960 | $109,280 |
| 4 | $33,000 | $99,000 | $132,000 |
| 5 | $38,680 | $116,040 | $154,720 |
| 6 | $44,360 | $133,080 | $177,440 |
| 7 | $50,040 | $150,120 | $200,160 |
| 8 | $55,720 | $167,160 | $222,880 |
| Each additional | +$5,680 | +$17,040 | +$22,720 |
UPMC Charity Care Income Thresholds, 2026 (Based on HHS Federal Poverty Guidelines)
Key point: A single parent with two children earning $75,000 falls below 300% FPL for a family of three ($81,960). That person's UPMC bill, for services like an ER visit, surgery, or specialist care, could be fully forgiven.
To apply for UPMC financial assistance, call 1-800-371-8359 (option 2) or request a paper application at any UPMC registration desk. The UPMC financial assistance application is also available at upmc.com/patients-visitors/paying-bill/services/apply.
Penn State Health Financial Assistance: Income Limits for 2026
Penn State Health operates the Milton S. Hershey Medical Center and multiple community hospitals across central Pennsylvania (Harrisburg, Reading, Lancaster, and surrounding areas).
Penn State Health 2026 Financial Assistance Thresholds
| FPL Bracket | What You Pay |
|---|
| 0% to 200% FPL | 100% forgiven (free care) |
| 201% to 300% FPL | Discounted care (sliding scale) |
| Above 300% FPL | Hardship review available |
Penn State Health covers both uninsured and underinsured patients. If you have insurance but face a large deductible or copay you cannot pay, you can still apply.
Penn State Health 2026 Dollar Thresholds
| Household Size | 200% FPL (Free Care Cutoff) | 300% FPL (Discount Cutoff) |
|---|
| 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 |
Penn State Health Charity Care Income Thresholds, 2026 (Based on HHS Federal Poverty Guidelines)
To apply, contact Penn State Health Financial Counseling at pennstatehealth.org/patients-visitors/billing-medical-records/financial-assistance. Staff are available Monday through Friday, 8:00 a.m. to 4:30 p.m.
Other Major Pennsylvania Hospital Systems in 2026
Pennsylvania has several other major systems with their own financial assistance programs:
Penn Medicine (Philadelphia area): Offers free care at or below 200% FPL, with discounts between 200% and 400% FPL. Apply at pennmedicine.org/for-patients-and-visitors/patient-information/insurance-and-billing/financial-assistance.
Allegheny Health Network (western PA): AHN offers financial assistance through a medical hardship review. According to Spotlight PA, AHN's threshold for a family of four earning around $96,450 (about 292% FPL) may require a hardship review rather than automatic forgiveness, a more restrictive standard than UPMC.
Temple Health (Philadelphia): Discounts bills for patients up to 400% FPL with free care up to a lower threshold. A family of four earning $96,450 might see approximately half their bill forgiven.
Key takeaway: The variation across Pennsylvania hospitals is significant. The same bill, the same income, and the same household size can produce different outcomes at UPMC versus AHN versus Penn Medicine. If your primary hospital denied your application or gave you a partial discount, applying at a different system for a second opinion on the standards is always worth asking about. Per research published in Health Affairs, income thresholds at nonprofit hospitals nationally range from 41% to 600% FPL.
Medical Debt and Your Credit Score in Pennsylvania: 2026 Status
The credit reporting landscape for medical debt changed significantly, then changed again.
What happened with the CFPB rule: A federal rule that would have banned all medical debt from credit reports was vacated by a federal court in July 2025. As of 2026, that sweeping ban is not in effect.
What is still protecting you:
- The three major credit bureaus (Equifax, Experian, and TransUnion) voluntarily removed paid medical collections from reports in 2023, regardless of amount.
- Medical collections under $500 were removed from credit reports by the bureaus voluntarily in April 2023.
- Unpaid medical debt under $500 does not appear on Equifax, Experian, or TransUnion reports.
- Medical debts paid in full are removed from reports even if they were previously reported.
Pennsylvania-specific: The Pennsylvania Fair Credit Extension Uniformity Act limits how collectors can contact and pressure you. It prohibits collectors from threatening legal action they do not intend to take or misrepresenting how much you owe. For more on state-specific protections, Commoner Law's Pennsylvania medical debt guide and State Regs Today outline what debt collectors can and cannot do.
Wage garnishment reminder: Pennsylvania's 100% wage exemption means no medical creditor can touch your paycheck, regardless of the debt amount. This applies even after a court judgment.
How to Check Your Pennsylvania Hospital Bill for Errors
Before you apply for charity care or pay anything, check the bill for errors. Billing errors in hospital statements are common: incorrect procedure codes, duplicate charges, and charges for services not received show up frequently.
The CoveredUSA Bill Analyzer compares each line on your Pennsylvania hospital bill to the Medicare rate for the same service. If a charge is significantly above the Medicare benchmark, it flags it as a potential overcharge so you can dispute it with the hospital before paying.
Upload your hospital bill to the free CoveredUSA Bill Analyzer to find errors, overcharges, and charity care options in 30 seconds.
How to Apply for Financial Assistance at a Pennsylvania Hospital
Enrollment window
Pennsylvania hospital financial assistance programs are open year-round. However, most hospitals require you to apply before a bill goes to a collection agency. UPMC typically allows applications within 180 days of receiving a bill. Penn State Health processes applications at any point while the balance is still held by the hospital.
Step-by-step application
- Call the hospital's financial counseling department before making any payment. Paying part of the bill does not disqualify you, but calling early gives you the most options.
- Request the Financial Assistance Application (FAP) or download it from the hospital's website. For UPMC, call 1-800-371-8359 option 2. For Penn State Health, call the number listed at pennstatehealth.org.
- Gather income documentation (see checklist below).
- Submit the completed application by mail, in person at the billing office, or online where available.
- Follow up within 30 days. UPMC states it will process applications within 30 days of receipt. Penn State Health notifies applicants by phone or letter.
- Request a billing hold while your application is pending. Ask the billing department to pause collection activity until a determination is made. Most hospitals will comply.
- Appeal if denied. Every hospital must have an appeal process under federal 501(r) rules. Ask for the appeals procedure in writing.
Documents needed
- Most recent federal tax return (Form 1040 with all schedules)
- Four most recent bank statements for all accounts
- Recent pay stubs (last 30 to 60 days)
- Proof of any other income: Social Security, disability, unemployment, child support
- If self-employed: profit and loss statement
- Photo ID
- Insurance card (even if you have insurance and are applying as underinsured)
Common reasons applications get denied
- Income documentation is incomplete or missing
- Application submitted after the bill was sold to a collections agency (apply early)
- Household income calculated differently than expected (hospital uses gross income; verify what they include)
- Assets exceeding the hospital's asset limit (some systems review savings and property for certain programs)
- Failure to respond to a request for additional documentation within the required window
What to Do If You Cannot Get Charity Care
If your income is above the thresholds or your application is denied, these options can still reduce what you owe:
Negotiate a payment plan: All nonprofit hospitals must offer payment plans. Ask for an extended term (12, 24, or 36 months) with zero interest.
Request an itemized bill and dispute errors: Ask for an itemized bill (line-by-line CPT codes and charges). Compare charges to the Medicare rate or use the CoveredUSA Bill Analyzer. Billing departments often resolve legitimate disputes with a corrected balance.
Apply for Pennsylvania Medicaid (Medical Assistance): Pennsylvania expanded Medicaid under the ACA. Adults with income up to 138% FPL ($22,243 for a single adult in 2026) qualify. Medicaid can cover bills retroactively for up to 3 months before your application date if you were eligible at the time. Apply at compass.dhs.pa.gov or call 1-866-550-4355.
Pennie (Pennsylvania ACA marketplace): If you have no insurance, Pennie is Pennsylvania's ACA marketplace. Subsidies are available for incomes up to 400% FPL and beyond in some cases. Enrolling now eliminates the risk of future large uninsured bills. Visit pennie.com or call 1-844-844-8040.
Dollar For: A nonprofit that helps patients apply for hospital financial assistance programs they may have missed. Available at dollarfor.org.
Frequently Asked Questions
Does UPMC forgive medical debt in Pennsylvania?
Yes, for qualifying patients. As of 2026, UPMC forgives 100% of bills for uninsured patients with household income at or below 300% of the Federal Poverty Level. For a family of four, that means annual income up to $99,000. Insured patients with large out-of-pocket costs may also qualify if those costs exceed 15% of gross household income.
What is the income limit for free care at Penn State Health in 2026?
Penn State Health provides free care to patients at or below 200% FPL. For 2026, that is $31,920 for a single person and $66,000 for a family of four. Patients between 200% and 300% FPL can receive discounted care on a sliding scale.
Can a Pennsylvania hospital garnish my wages for a medical bill?
No. Pennsylvania exempts 100% of wages from garnishment for consumer debts, which includes medical debt. Even if a hospital wins a court judgment against you, it cannot take money from your paycheck. This is one of the strongest wage exemptions in the country.
Does medical debt still show up on my credit report in Pennsylvania in 2026?
Medical debt under $500 does not appear on Equifax, Experian, or TransUnion reports after the 2023 voluntary bureau changes. Paid medical collections are removed regardless of amount. However, unpaid medical debt over $500 can still appear. The broader federal ban proposed by the CFPB was vacated by a court in July 2025 and is not in effect as of 2026.
How long do I have to apply for charity care after getting a hospital bill in Pennsylvania?
It depends on the hospital. UPMC typically allows applications up to 180 days from the date of the bill. Penn State Health accepts applications while the bill is still held by the hospital before it goes to an outside collection agency. Apply as soon as possible. Do not wait until the bill goes to collections.
Can I apply for financial assistance if I have health insurance?
Yes. Uninsured and underinsured patients both qualify. If you have insurance but face a deductible or copay that is unaffordable relative to your income, UPMC, Penn State Health, and most other Pennsylvania nonprofit hospitals will still review your application. UPMC's 15% of gross income threshold applies to insured patients with high out-of-pocket costs.
What is the difference between charity care and financial assistance?
They refer to the same thing. Hospitals use different terminology: some say "charity care," some say "financial assistance," and some say "hospital discount program." They all mean the hospital will reduce or eliminate your bill based on income and household size.
How do I know if my Pennsylvania hospital bill has errors?
Request an itemized statement with CPT codes for every service. Compare each charge to published Medicare rates for your region. The CoveredUSA Bill Analyzer can do this automatically. Upload your bill at coveredusa.org/medical-bill-analyzer and it will flag charges that appear inflated relative to the Medicare benchmark.
