Trinity Health, the nation's largest Catholic nonprofit health system, operates 92 hospitals across 22 states and maintains a systemwide financial assistance policy covering patients up to 400% of the Federal Poverty Level (FPL). As of 2026, that means a family of four earning up to $132,000 per year may qualify for at least a partial discount on a Trinity Health hospital bill. Patients below 200% FPL can receive a full 100% write-off on medically necessary care.
Quick Answer: Trinity Health provides free care (100% discount) to uninsured or underinsured patients with household income at or below 200% FPL. Patients between 200% and 400% FPL receive a partial discount equal to the Medicare rate. Anyone facing medical costs that exceed 20% of annual household income also qualifies for catastrophic cost relief, regardless of insurance status. Applications are available at any Trinity Health facility at no cost.
Who Qualifies for Trinity Health Financial Assistance in 2026
Trinity Health's charity care program uses two main eligibility gates: income relative to the FPL and whether the care was medically necessary.
Full discount (100% write-off): Your household income is at or below 200% of the 2026 FPL. This covers emergency care and all medically necessary inpatient and outpatient services billed by a Trinity Health facility.
Partial discount (Medicare rate reduction): Your income falls between 200% and 400% FPL. The discount mirrors what Medicare would pay, which is typically 20 to 40 percent below the hospital's standard charges.
Catastrophic cost relief: Your out-of-pocket medical expenses for a single episode of care exceed 20% of your annual household income. This provision can apply even if you have insurance; copays and deductibles may be included in the eligible balance.
Services excluded from all tiers include elective cosmetic procedures and care deemed not medically necessary. Trinity Health also requires patients to first pursue any coverage they may be eligible for, including Medicaid and ACA marketplace plans, before a charity care award is finalized.
2026 Income Limits by Household Size
The table below shows the 2026 federal poverty level thresholds published by the U.S. Department of Health and Human Services, and what 200% and 400% FPL translate to in annual dollars. These are the benchmarks Trinity Health uses systemwide.
Trinity Health Financial Assistance Income Limits, 2026 (48 Contiguous States and D.C.)
| Household Size | 100% FPL | 200% FPL (Full Discount) | 400% FPL (Partial Discount Upper Limit) |
|---|
| 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 person | +$5,680 | +$11,360 | +$22,720 |
Source: HHS ASPE 2026 Poverty Guidelines
Alaska and Hawaii use higher FPL amounts. In Alaska, 100% FPL starts at $19,950 for one person; in Hawaii it starts at $18,360. If you receive care at a Trinity Health facility in those states, multiply those base figures by 2 or 4 to find your applicable threshold.
Trinity Health Hospitals by Region
Trinity Health's footprint spans 22 states. Major regional systems that operate under the same systemwide financial assistance policy include:
- Trinity Health Michigan: nine hospitals in Ann Arbor, Chelsea, Grand Haven, Grand Rapids, Howell, Livonia, Muskegon, Oakland, and Shelby
- Mount Carmel Health (Ohio): Trinity Health's Ohio affiliate
- Saint Joseph Health System (Indiana): Mishawaka and Plymouth campuses
- Trinity Health Mid-Atlantic: Pennsylvania, Maryland, and New Jersey region
- Trinity Health of New England: Connecticut and Massachusetts affiliate
- MercyOne (Iowa): Trinity Health-affiliated Iowa network
- Saint Alphonsus Health System (Idaho): Boise and surrounding region
- Saint Mary's Healthcare (Georgia)
Every listed system applies the same core FPL-based discount tiers. Application forms and plain language policy summaries are available free of charge at any facility.
How to Read Your Bill Before You Apply
A hospital bill from any Trinity Health facility can run dozens of line items. Before you submit a financial assistance application, the CoveredUSA Bill Analyzer can compare each charge on your bill to the Medicare reimbursement rate so you understand exactly which line items are standard, which are inflated, and what a fair negotiated price looks like. Spotting overcharges before applying means you can negotiate from a better position even if your income falls just above the 400% cutoff.
How to Apply for Trinity Health Financial Assistance
Enrollment window: Financial assistance applications are accepted at any time, before or after a bill is issued. Trinity Health facilities are required by IRS 501(r) rules to offer financial assistance for up to 240 days after the first billing statement.
Step-by-step application process:
- Contact the patient financial services office at the Trinity Health facility where you received care. Ask specifically for a financial counselor, not general billing.
- Request the Financial Assistance Application in your preferred language. Applications and plain language policy summaries are available free of charge in languages spoken by 10% or more of the community served.
- Complete the application fully, including all household members' income and expenses. Missing information is the most common reason applications are delayed.
- Gather and attach supporting documents (see checklist below). Submitting a complete package the first time speeds up the review.
- Submit the application by one of four methods: in person at the patient access department, by mail to the facility's billing office, by fax, or by email if the facility accepts digital submissions.
- Follow up within 10 to 14 business days if you have not received a written determination. You can request an appeal in writing if the initial determination is unfavorable.
- Reapply each year if your situation is ongoing. Financial assistance eligibility is not permanent; income is verified annually.
Documents typically required:
- Completed Trinity Health Financial Assistance Application form
- Most recent federal tax return (1040) for all household members
- Two to three months of recent pay stubs for all employed household members
- Bank statements (checking and savings) from the past 60 to 90 days
- Social Security award letter if applicable
- Unemployment benefit statement if applicable
- Documentation of any other income sources (rental income, child support, etc.)
Common reasons applications are denied:
- Incomplete or missing documentation (most frequent cause)
- Patient is eligible for Medicaid or an ACA marketplace plan and refuses to apply for those programs first
- Services rendered were elective or not medically necessary
- Income exceeds 400% FPL and catastrophic cost threshold is not met
- Application submitted after the 240-day window following the first billing statement
The Medicare Discount Rate: What It Actually Means
The partial discount for patients between 200% and 400% FPL is described as "the Medicare rate." This matters because hospitals charge uninsured patients the chargemaster rate, which can be two to five times what Medicare actually pays for the same procedure. The 2026 Medicare reimbursement rate for a typical inpatient hospital stay averages roughly 65 to 75 cents per dollar of chargemaster price. In practice, qualifying for the partial discount means your bill shrinks substantially, even if it does not disappear entirely.
For example, a $20,000 emergency surgery billed at chargemaster rates might reflect a Medicare-equivalent payment closer to $13,000 to $15,000. If you qualify for the 200 to 400% FPL tier, Trinity Health applies that Medicare rate as your adjusted balance before any payment plan or residual balance.
What Counts as Medically Necessary
"Medically necessary" follows the standard clinical definition: care required to diagnose, prevent, or treat a medical condition. Trinity Health's policy covers emergency visits, inpatient stays, surgery, diagnostic imaging, lab work, and chemotherapy or radiation ordered as treatment, all when performed at a Trinity Health facility. It also covers outpatient services billed by Trinity Health directly.
What it does not cover: cosmetic procedures with no medical indication, elective weight-loss surgery performed solely for appearance, and services billed by independent physicians who practice at Trinity Health facilities but are not employed by Trinity Health. That last point is significant: if your surgeon is an independent contractor rather than a Trinity Health employee, their portion of the bill requires a separate financial assistance application with that physician's practice.
Catastrophic Cost Protection for Insured Patients
Insured patients are not excluded from Trinity Health's financial assistance program. If you have coverage but face an out-of-pocket burden exceeding 20% of your annual household income from a single episode of care, you can submit a financial assistance application for the remaining balance after insurance pays. Copays, deductibles, and coinsurance are all eligible for review under the catastrophic cost provision.
This provision is especially relevant for patients with high-deductible health plans. A family earning $80,000 with a $10,000 deductible who receives a $15,000 bill after insurance would owe $10,000 out of pocket, which is 12.5% of income, below the catastrophic threshold. But a family earning $50,000 in the same situation owes the same $10,000, which is 20% of income, exactly at the threshold. A financial counselor can help you calculate whether you qualify.
How the CoveredUSA Bill Analyzer Can Help
Whether you are applying for charity care or negotiating a payment plan, knowing what your bill should actually cost is essential. Upload your hospital bill to the free CoveredUSA Bill Analyzer to find errors, overcharges, and charity care options in 30 seconds. The CoveredUSA Bill Analyzer compares line-item charges to Medicare benchmarks and flags any amounts that appear above the standard rate, giving you a documented basis for appeal or negotiation before you finalize a payment arrangement with Trinity Health billing.
Frequently Asked Questions
Does Trinity Health financial assistance cover all 92 hospitals?
Yes. Trinity Health uses a mirror policy across all member facilities. The same income tiers, FPL percentages, and application process apply at every Trinity Health hospital and most Trinity Health-affiliated outpatient clinics, though individual facilities manage their own applications. Contact the patient financial services office at the specific facility where you received care to start the process.
Can I apply for financial assistance after my bill goes to collections?
Under IRS 501(r) regulations, nonprofit hospitals including all Trinity Health facilities must give patients at least 240 days from the first billing statement to apply for financial assistance before initiating "extraordinary collection actions" such as reporting to credit agencies, filing suit, or placing the account with a third-party collector. If your account is already in collections, contact Trinity Health patient financial services directly and ask them to pull the account back for financial assistance review. Many facilities will comply if you are within the 240-day window.
Does Trinity Health charity care cover physician bills separately from the hospital bill?
No. Financial assistance applies only to charges billed directly by Trinity Health. If an independent physician or physician group provided services at a Trinity Health facility, their bill is separate. Ask any physician who treated you whether they are employed by Trinity Health or are independent contractors, then apply separately to their billing office if needed.
What if I earn just above the 400% FPL cutoff?
Trinity Health's catastrophic cost provision has no hard income ceiling. If your medical costs for one episode of care exceed 20% of your household income, you can apply for relief regardless of where your income falls relative to 400% FPL. Document your total out-of-pocket costs and your annual income carefully on the application.
How long does the financial assistance review take?
Most Trinity Health facilities aim to complete reviews within 30 days of receiving a complete application. Incomplete applications or missing documentation are the primary cause of delays. Submit a full package with all required documents to avoid going back and forth with the billing office.
Is there an appeals process if my application is denied?
Yes. Trinity Health facilities are required to provide a written denial with the reason. You can submit a written appeal with additional documentation. Common successful appeals involve patients who initially submitted incomplete income documentation or who received care that was initially misclassified as elective.
Do I need to be uninsured to qualify for Trinity Health financial assistance?
No. Uninsured and underinsured patients are both eligible. "Underinsured" in Trinity Health's policy means patients whose coverage leaves them with significant out-of-pocket costs. Insured patients whose bills trigger the catastrophic cost threshold (20% of annual income) are eligible regardless of income tier.
What is the difference between Trinity Health and Trinity Health System?
There are two separate entities that use similar names. Trinity Health (headquartered in Livonia, Michigan) is the large 92-hospital Catholic system described in this article and operating at trinity-health.org. Trinity Health System (in Steubenville, Ohio) is a smaller, separate regional system. Confirm which system billed you before applying. Applications go to the facility that provided care, and the two systems have separate financial assistance offices.
