Quick Answer: As of 2026, Virginia prohibits hospitals and collectors from reporting medical debt to credit bureaus (HB 1370, effective July 2024) and bans wage garnishment for patients who qualify for financial assistance (HB 1725, effective July 1, 2026). Inova's Financial Assistance Program (FAP) covers 100% of your bill at or below 400% of the Federal Poverty Level.
If you have received a hospital bill in Virginia, two recent state laws give you more leverage than most Americans have. Virginia banned medical debt credit reporting in July 2024 and added a second layer of protection, effective July 1, 2026, that caps interest on outstanding balances, requires 120-day waiting periods before collection, and blocks wage garnishment for patients who qualify for charity care. On top of those laws, major Virginia health systems like Inova offer tiered financial assistance that can cut your bill to zero. Here is what you need to know to use all of it.
What Virginia's 2024 Credit Reporting Ban Actually Does
Virginia Code Section 59.1-444.4 (HB 1370) took effect July 1, 2024. It prohibits:
- Hospitals, clinics, physician practices, and emergency medical services agencies from sending any medical debt to a consumer reporting agency
- Debt collectors and medical debt buyers from reporting a medical debt they purchased or are trying to collect
"Medical debt" under this law covers charges from health care services, durable medical equipment, prescription drugs, and transportation to receive care. One exception: if you paid a medical bill with a credit card and now owe the credit card company, that debt is not covered.
What this means in practice: A hospital bill from a Virginia provider cannot legally appear on your credit report. If you have a collection account from a Virginia medical provider on your credit report dated after July 1, 2024, you can dispute it and the bureau must remove it.
The federal Consumer Financial Protection Bureau also finalized a rule in 2024 removing medical debt from credit reports nationally, though a federal court later paused that rule. Virginia's state law stands independently and is not affected by the federal court ruling.
Virginia Medical Debt Protection Act (HB 1725): Effective July 1, 2026
Governor Youngkin signed HB 1725 on May 2, 2025. It takes effect July 1, 2026 and applies to large health care facilities (hospitals and outpatient facilities), large physician practices with annual revenues of $20 million or more, medical debt collectors, and medical debt buyers.
Key provisions as of 2026:
Interest and late fee cap: No interest or late fees can be charged for the first 90 days after the final invoice due date. After 90 days, the cap is 3% per year. That is far below the typical 18% to 29% that a credit card would charge on the same balance.
120-day collection hold: No extraordinary collection action, including wage garnishment, property liens, home foreclosure, or body attachment, can begin until 120 days after the invoice due date. This gives you four months to apply for financial assistance or negotiate a payment plan before a collector can escalate.
30-day written notice: Before any extraordinary collection action, the creditor must send a written notice at least 30 days in advance. That notice must state what action they plan to take and whether you may qualify for financial assistance.
Wage garnishment ban for assisted patients: If you qualify for a hospital's charity care or financial assistance policy, the collector cannot garnish your wages. Period.
Overpayment refund rule: If you paid more than you owed after financial assistance is applied, the provider or collector must refund the excess within 60 days.
Debt sale restrictions: Medical debt can only be sold to buyers who agree to follow these same rules: capped interest, prohibited garnishment for assisted patients, and obligation to return the debt if you later qualify for assistance.
Violations of HB 1725 are treated as prohibited practices under Virginia's Consumer Protection Act, meaning you can sue for damages, attorney's fees, and civil penalties.
Inova Financial Assistance Program (FAP): Income Limits for 2026
Inova Health System serves Northern Virginia and is one of the largest hospital networks in the state, with facilities in Fairfax, Falls Church, Alexandria, Loudoun, Prince William, and other areas.
Inova's FAP uses the Federal Poverty Guidelines published by HHS. As of 2026:
- At or below 400% FPL: 100% financial assistance discount (your bill is free)
- Above 400% FPL: Partial discount on a sliding scale; Inova reviews on a case-by-case basis
The 2026 Federal Poverty Guidelines for the 48 contiguous states (which Virginia follows):
| Household Size | 100% FPL | 200% FPL | 300% FPL | 400% FPL (Inova free care cutoff) |
|---|
| 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 | $5,680 | $11,360 | $17,040 | $22,720 |
If your household income is at or below the 400% FPL column for your family size, Inova is required to offer you a 100% discount. A family of four earning up to $132,000 qualifies for free care at Inova under the 2026 guidelines.
Inova also has no asset test. They do not look at your savings, home value, or car. Only income and household size count.
How to Apply for Inova FAP: Step by Step
Step 1: Request the application. You can get it from the financial counselor at any Inova facility, download it from inova.org, or apply through your Inova MyChart account. The form is available in multiple languages.
Step 2: Gather your documents. You will need:
- Proof of income for all household members (pay stubs, tax return, Social Security award letter, or a self-certification form if you have no income)
- Proof of household size (tax return, birth certificates, or a signed statement)
- Proof of Virginia residency (utility bill, lease, or driver's license)
Step 3: Submit before or after your bill. You can apply retroactively. Inova reviews accounts for financial assistance even after you have received a final bill. If you have already made payments and it turns out you qualified for the 100% discount, Inova must refund the excess within 60 days under HB 1725.
Step 4: Call the Inova Financial Assistance Team if you have questions. The direct line is 571-472-5880, Monday through Friday, 8 a.m. to 4:30 p.m.
Step 5: Appeal if denied. Inova's policy allows you to provide additional documentation and request a second review if your initial application is denied.
If you received care at a different Virginia hospital, the application process is similar. Most Virginia hospitals are nonprofit and are legally required to offer a charity care program. VCU Health, Sentara, and Bon Secours all maintain FAPs with income thresholds ranging from 200% to 400% FPL depending on the facility.
How to Check Your Bill for Errors Before Paying
Virginia's new protections give you time, 120 days before any collection action, which is also time to audit your bill. Hospital billing errors are common. Studies have found errors in a majority of hospital bills, including duplicate charges, unbundled procedures that should be billed together, and charges for services that were never delivered.
Before paying, upload your itemized bill to the CoveredUSA Bill Analyzer. The CoveredUSA Bill Analyzer compares each line item on your bill to the Medicare reimbursement rate, which is the closest publicly available benchmark for what a service actually costs. It flags lines that are priced significantly above that rate, identifies common billing code errors, and highlights whether you may qualify for the hospital's financial assistance program, all in about 30 seconds.
This matters because Virginia's HB 1725 requires that collection notices include a statement about available financial assistance. If a collector contacts you and does not include that information, that is a violation you can act on.
Other Virginia Hospitals with Financial Assistance Programs
Beyond Inova, here are income thresholds at major Virginia health systems as of 2026:
| Hospital System | Free Care Threshold | Discounted Care Threshold |
|---|
| Inova Health System | 400% FPL | Sliding scale above 400% |
| VCU Health (Richmond) | 200% FPL | Up to 400% FPL |
| Sentara Healthcare | 200% FPL | Up to 400% FPL |
| Bon Secours Mercy Health | 200% FPL | Up to 300% FPL |
| Carilion Clinic (Roanoke) | 200% FPL | Up to 400% FPL |
These thresholds are approximate. Each facility publishes its own Financial Assistance Policy, which under Virginia law must be posted on its website and made available in plain language at the facility.
What to Do If a Collector Violates Virginia Law
If a Virginia medical collector violates HB 1370 (credit reporting ban) or HB 1725 (collection protections):
- Document everything. Save all written communications, billing statements, and any credit report showing the medical debt.
- File a complaint with the Virginia Attorney General's Consumer Protection Section at ago.virginia.gov/file-complaint. The AG can pursue civil penalties under the Virginia Consumer Protection Act.
- Dispute credit report entries. If a Virginia medical debt appears on your credit report after July 1, 2024, file a dispute with Equifax, Experian, and TransUnion. Reference Virginia Code 59.1-444.4 in your dispute letter.
- Consult an attorney. HB 1725 gives you a private right of action, meaning you can sue the collector directly for damages plus attorney's fees.
Virginia Medicaid (Cardinal Care) and Medical Debt
If your income is at or below 138% FPL, about $22,024 for a single adult in 2026, you likely qualify for Cardinal Care, Virginia's Medicaid program. Virginia expanded Medicaid in 2019 under the ACA, so there is no coverage gap for working-age adults as there is in some other states.
Cardinal Care covers hospital, outpatient, emergency, and specialty care with low or no cost-sharing. If you have ongoing medical bills and low income, enrolling in Cardinal Care is the most complete solution: future bills will be covered by Medicaid rather than going to collections at all.
You can apply through CommonHelp at commonhelp.virginia.gov or by calling 1-855-242-8282.
Frequently Asked Questions
Does Virginia's credit reporting ban apply to old medical debt?
HB 1370 took effect July 1, 2024. It applies to medical debt reporting on or after that date. If a collector reported your Virginia medical debt to a credit bureau after July 1, 2024, that is a violation regardless of when the underlying medical service occurred. For debt reported before July 1, 2024, Virginia's state law does not apply retroactively, though federal dispute rights under the FCRA still exist.
Can a hospital still sue me for medical debt in Virginia?
Yes. Virginia's laws restrict certain collection tactics (credit reporting, wage garnishment for assisted patients, liens) but do not eliminate the ability to sue. Virginia's statute of limitations for medical debt lawsuits was reduced to 3 years (HB 34, effective July 2024). After 3 years from the date of default, a hospital generally cannot win a lawsuit to collect the debt.
What if I can't afford Inova's payment plan options?
If Inova's payment plan would create a financial hardship, request a hardship review or apply for the full FAP. Under HB 1725, Inova cannot charge interest for the first 90 days and is capped at 3% per year after that. You can also ask for an extended payment plan. If your income is near the 400% FPL threshold, a small difference in documentation (accounting for dependent care expenses or medical expenses already paid) can shift you from a sliding-scale discount to the full 100% assistance tier.
How does the CoveredUSA Bill Analyzer help with Virginia medical debt?
Upload your itemized bill to the CoveredUSA Bill Analyzer and it will compare each charge to benchmark rates, flag potential billing errors, and identify whether you may qualify for hospital financial assistance. This is most useful before you pay or before you agree to a payment plan, since errors and assistance eligibility together can reduce your bill substantially.
Does Virginia law apply to out-of-state collectors?
Yes. If the medical service was provided at a Virginia facility, the debt is subject to Virginia law regardless of where the collection agency is located. If a non-Virginia collector tries to report Virginia medical debt to a credit bureau, they are violating Virginia Code 59.1-444.4 and you can file a complaint or dispute the entry.
What is the income limit for free care at Virginia hospitals in 2026?
It varies by hospital. Inova's cutoff for 100% free care is 400% of the Federal Poverty Level, which equals $63,840 for a single person and $132,000 for a family of four in 2026. Most other Virginia nonprofit hospitals use 200% FPL as the free care cutoff. All nonprofit hospitals in Virginia are required to offer a financial assistance program under state and federal nonprofit hospital rules.
Can a Virginia hospital charge me interest on my unpaid bill?
As of July 1, 2026 (when HB 1725 takes effect), large health care facilities and medical debt buyers cannot charge any interest or late fees for the first 90 days after your final invoice is due. After 90 days, the rate is capped at 3% per year. Before July 1, 2026, no state cap exists, though many hospitals have their own internal policies limiting interest.
What if I already paid a bill I did not know I could get help with?
Apply for financial assistance retroactively. Virginia hospitals are required to accept retroactive applications. If your application is approved and you paid more than you owed, the hospital must refund the excess within 60 days under HB 1725. Call the financial counseling office at the hospital where you received care and ask about retroactive financial assistance review.
If you have a hospital bill from a Virginia provider, upload it to the free CoveredUSA Bill Analyzer to find errors, overcharges, and charity care options in 30 seconds.
