Quick Answer: Texas Children's Hospital provides free or discounted care to families who cannot pay their bills. As of 2026, families earning up to 400% of the Federal Poverty Level (FPL) may qualify for a sliding-scale discount, and those at the lowest income levels can receive 100% free care. You do not need to be uninsured to apply.
A hospital bill from Texas Children's Hospital can run into thousands of dollars even with insurance. What most families don't know is that the hospital operates a formal financial assistance program, sometimes called charity care, that can eliminate or sharply reduce those charges. If your Texas family income falls below certain thresholds relative to the 2026 Federal Poverty Level, you may owe nothing at all.
This guide covers the 2026 income limits, discount tiers, required documents, and exact steps to apply at any Texas Children's location.
What Is Texas Children's Hospital Financial Assistance?
Texas Children's Hospital is a nonprofit hospital system in Houston, Texas. As a 501(c)(3) organization, it is required by federal law under Section 501(r) of the Affordable Care Act to maintain a financial assistance program and to make that program reasonably available to patients. The hospital provides more than $13 million in charity care annually, according to its community benefit reports.
The program covers medically necessary services. Cosmetic procedures, elective non-covered items, and services that Medicare or Medicaid would consider non-covered are generally excluded. But for emergency care, surgeries, inpatient stays, outpatient procedures, lab work, and similar services, the program applies broadly.
Eligibility is open to Texas residents and U.S. citizens or lawful residents. International patients are directed to Texas Children's International Patient Services instead.
2026 Income Limits: Who Qualifies?
Texas Children's uses the annual HHS Federal Poverty Guidelines published each January to determine eligibility. For 2026, the base poverty level for a family of four in Texas (48 contiguous states) is $33,000 per year according to aspe.hhs.gov.
The hospital applies a sliding scale from 56.5% to 100% discount based on where your household income falls relative to FPL. Families below 200% FPL typically receive the largest discounts or full free care. Families between 200% and 400% FPL receive partial discounts on a graduated basis.
Texas Children's Hospital Financial Assistance Income Reference Table (2026)
The table below shows 100% FPL and common multiples for each household size in Texas. Use this to estimate where your income falls before applying.
| Household Size | 100% FPL (2026) | 200% FPL | 300% FPL | 400% FPL |
|---|
| 1 | $15,960 | $31,920 | $47,880 | $63,840 |
| 2 | $21,640 | $43,280 | $64,920 | $86,560 |
| 3 | $27,320 | $54,640 | $81,960 | $109,280 |
| 4 | $33,000 | $66,000 | $99,000 | $132,000 |
| 5 | $38,680 | $77,360 | $116,040 | $154,720 |
| 6 | $44,360 | $88,720 | $133,080 | $177,440 |
| 7 | $50,040 | $100,080 | $150,120 | $200,160 |
| 8 | $55,720 | $111,440 | $167,160 | $222,880 |
| Each additional person | +$5,680 | +$11,360 | +$17,040 | +$22,720 |
Source: 2026 HHS Poverty Guidelines, aspe.hhs.gov. Texas Children's Hospital Financial Assistance Policy.
Key thresholds to know:
- At or below ~200% FPL: Most families in this range qualify for the highest discount levels, which can reach 100% (no out-of-pocket cost for covered services).
- 201% to 400% FPL: Families receive a partial sliding-scale discount. The exact percentage depends on where in that range your income falls.
- Above 400% FPL: You generally do not qualify for charity care, but you may still be eligible for payment plan arrangements or other financial counseling services.
You do not need to be uninsured. Underinsured families with high copays, deductibles, or out-of-pocket costs they cannot afford are also eligible to apply.
Before you estimate your bill or try to negotiate a payment, the CoveredUSA Bill Analyzer can compare each charge on your Texas Children's Hospital statement against Medicare benchmark rates, flagging potential overcharges and identifying whether charity care is likely to apply to your specific balance. Uploading takes about 30 seconds.
What the Sliding Scale Actually Means
The sliding scale means your discount percentage increases as your income decreases relative to FPL. Here is a simplified view of how that works in practice:
| Income Range | Approximate Discount |
|---|
| Below ~150% FPL | Up to 100% (free care) |
| 150% to 200% FPL | High discount, potentially 85%-100% |
| 200% to 300% FPL | Moderate discount, roughly 56%-84% |
| 300% to 400% FPL | Partial discount, lower end of scale |
| Above 400% FPL | Generally not eligible |
These are approximate ranges based on Texas Children's published policy language and the hospital's stated 56.5% to 100% discount band. Exact percentages are calculated case-by-case.
Even the low end of the scale (56.5%) is substantial. On a $20,000 hospital bill, that translates to more than $11,000 in discounts.
How to Apply for Texas Children's Hospital Financial Assistance
Texas Children's accepts applications for up to 240 days after you receive your first bill. That means even if your account is past due or has been sent to a collection agency, you can still apply and the hospital must consider your application.
Documents You Will Need
Gather these before contacting a financial counselor:
- Recent federal tax return (1040) or, if you did not file, W-2 forms from the past year
- Pay stubs for the most recent 30 days (for all employed adults in the household)
- Proof of any other income: Social Security award letters, child support documentation, unemployment benefit letters
- Government-issued photo ID
- Social Security numbers for all household members (or ITIN if applicable)
- Insurance cards and any explanation of benefits (EOB) if you have insurance
- A copy of the hospital bill you are disputing
Step-by-Step Application Process
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Call the financial counseling line. For the main Medical Center campus, call 832-824-5505. Other locations: West Campus 832-227-2100, The Woodlands 936-267-5400, Pavilion for Women 832-826-3300, North Austin 737-229-2250. Counselors are available Monday through Friday, 7 a.m. to 5 p.m. You can also call the general line at 832-824-2300.
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Request the financial assistance application. Ask the counselor to send you the form, or ask to complete it in person. The hospital provides the application in both English and Spanish. Multi-lingual assistance is available for other languages through the hospital's translation services.
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Complete the application and attach your documents. Fill out all household income information accurately. The hospital uses gross income (before taxes), not net.
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Submit the application. You can bring it in person to the Financial Counseling office at the following locations:
- Main Medical Center: 3rd floor, West Tower
- West Campus: 1st floor
- The Woodlands: 1st floor
- Pavilion for Women: 3rd floor
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Wait for an eligibility determination. The hospital reviews your application and notifies you of your discount level. If approved, the discount applies to your outstanding balance and to any future services at that income level.
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Appeal if necessary. If your application is denied, you have the right to appeal. Contact the financial counseling office and ask about the appeals process.
Common Reasons Applications Get Denied
- Income documentation is incomplete or missing (most common)
- Only one household member's income was reported when multiple earners are present
- Application submitted after the 240-day window from the first billing date
- Applicant listed as an international patient rather than a Texas resident
- Services were not medically necessary under Medicare or Medicaid standards
Texas Children's Hospital Locations and Financial Counseling Contacts
| Location | Address | Financial Counseling Phone |
|---|
| Main Medical Center (Houston) | 6621 Fannin St, Houston, TX 77030 | 832-824-5505 |
| West Campus (Houston) | 18200 Katy Freeway, Houston, TX 77094 | 832-227-2100 |
| The Woodlands | 17600 Interstate 45 S, The Woodlands, TX 77384 | 936-267-5400 |
| Pavilion for Women | 6651 Main St, Houston, TX 77030 | 832-826-3300 |
| North Austin | 4501 W Parmer Ln, Austin, TX 78727 | 737-229-2250 |
Texas Children's Financial Assistance Policy is available for download in English and Spanish at texaschildrens.org.
What If You Already Have Insurance?
Having insurance does not disqualify you. If your plan's cost-sharing, deductibles, or out-of-pocket maximums leave you with a balance you cannot afford, financial assistance can cover some or all of the remaining patient responsibility. The hospital calculates assistance based on your income relative to FPL and your remaining balance after insurance has paid its portion.
This is especially relevant in Texas, where Medicaid does not cover most adults (Texas has not expanded Medicaid under the ACA). Many working families in Texas earn too much for Medicaid but still struggle with high hospital bills, per medicaid.gov. Texas Children's financial assistance is designed to fill that gap.
If you have questions about whether you might qualify for Medicaid or CHIP for your child (children qualify up to 201% FPL in Texas according to yourtexasbenefits.com), the financial counselors can help screen for those programs as well before calculating your charity care eligibility.
Get Your Bill Analyzed First
Before you apply, it helps to know exactly what you are being charged and whether those charges are accurate. Hospital billing errors are common, and overcharges can inflate the balance you are trying to reduce.
Upload your Texas Children's Hospital bill to the free CoveredUSA Bill Analyzer. The tool checks each line item against Medicare benchmark rates, identifies charges that look inflated or duplicated, and provides a plain-language summary of your bill. That information gives you a clearer starting point before you sit down with a financial counselor.
Upload your hospital bill to the free CoveredUSA Bill Analyzer to find errors, overcharges, and charity care options in 30 seconds.
Frequently Asked Questions
Does Texas Children's Hospital financial assistance cover past bills?
Yes. You can apply for up to 240 days after receiving your first bill. Even if your account has been sent to a collection agency, Texas Children's must consider your application if it falls within that window. Contact the financial counseling office and mention the date of your first billing statement.
What income does Texas Children's count when calculating eligibility?
The hospital uses gross household income, meaning total income before taxes and deductions, for all adults living in the household. This includes wages, self-employment income, Social Security benefits, child support, alimony, rental income, and other regular income sources. It does not include assets like savings accounts or home equity.
Can I get financial assistance if I have no income?
Yes. Households with zero or very low income typically qualify for the maximum discount, which can be 100% of the covered charges. You will need to document your income situation, such as a letter from an employer confirming you are not currently working, bank statements, or an attestation form.
How long does the application review take?
Texas Children's does not publish a specific review timeline. In practice, straightforward applications with complete documentation are often processed within a few weeks. Complex cases or appeals may take longer. Ask your financial counselor for an estimated timeline at the time you submit.
What happens to my bill while the application is under review?
Contact the billing office and let them know you have submitted a financial assistance application. They can note your account and pause or modify collection activity while the application is pending. This is important to request explicitly.
Does the financial assistance cover outpatient visits and emergency room care?
Yes. The program covers medically necessary services across all Texas Children's care settings, including inpatient stays, outpatient procedures, emergency department visits, and clinic appointments. The key requirement is that the service be medically necessary under Medicare, Medicaid, or standard industry criteria.
Can undocumented families apply for financial assistance at Texas Children's?
The published policy states eligibility is generally reserved for U.S. citizens and lawful residents. Families with undocumented members should contact a financial counselor directly to discuss their situation, as individual circumstances vary and the hospital does provide emergency care regardless of immigration status.
Is there a phone number for Spanish speakers at Texas Children's Hospital financial assistance?
Yes. Financial counselors are available who are fluent in both English and Spanish. The general financial counseling line is 832-824-2300. Additional multi-lingual support is available through the hospital's translation services for other languages.
