Free and discounted hospital care in Massachusetts

Apply for MassHealth first

Apply for MassHealth first. In Massachusetts one application (ACA-1) checks you for MassHealth, Health Connector plans and the Health Safety Net together. Hospital financial counselors help with it for free, and most hospital financial assistance policies require you to apply before the hospital will review its own discounts. MassHealth phone is (800) 841-2900.

Applications and qualifications are available on line here: Member Booklet for Health and Dental Coverage and Help Paying Costs (ACA-1).

Source, checked 2026-11-10

Health Safety Net

The Health Safety Net (HSN) pays for some care at Massachusetts acute care hospitals and community health centers for low-income Massachusetts residents who are uninsured or underinsured. It is not insurance. With family income up to 150% of the poverty level there is no deductible. From above 150% up to 300% there may be a yearly deductible based on income. It can pay after other insurance, including private plans, Medicare and some MassHealth programs. You apply with the same application used for MassHealth, so MassHealth is checked first. There is no member card. You must renew every year. HSN pays the hospital's own charges. Doctors who bill separately, and labs or x-rays run by private companies, may not be covered. HSN Medical Hardship can help residents at any income when medical bills are a large share of income.

Income levels in the program are free up to 150%, discount up to 300% of poverty level.

Applies to acute care hospitals and community health centers.

Residency. Massachusetts resident

Fill out the MassHealth application (ACA-1), online through the Health Connector, on paper, or with a hospital or health center financial counselor. The same application decides MassHealth, Health Connector plans and HSN. Bring proof of identity. Medical Hardship needs a separate application that a hospital or health center counselor submits for you.

Program phone (800) 841-2900

Massachusetts residents with income between 0-150% of the FPL may be eligible for the Health Safety Net.

Program source, checked 2026-11-10

Health Safety Net Medical Hardship

A Massachusetts resident at any income can get help through HSN Medical Hardship when allowable medical bills are larger than a set share of countable income. The share is 10% of income up to 205% of the poverty level, 15% from 205.1% to 305%, 20% from 305.1% to 405%, 30% from 405.1% to 605%, and 40% above 605.1%. You pay that share. A hospital or health center financial counselor files the application with itemized bills, proof of income, proof of Massachusetts residency and proof of identity.

Applies to acute care hospitals and community health centers.

Ask a hospital or community health center financial counselor to submit a Medical Hardship application.

Income Level Percentage of Countable Income 0 - 205% FPL 10% 205.1 - 305% FPL 15% 305.1 - 405% 20%

Program source, checked 2026-11-10

101 CMR 613.08 Collection protections for Low Income Patients

Hospitals and health centers paid by HSN may not take collection action against a patient approved as a Low Income Patient for HSN-covered services received while approved, except copays and deductibles. Partial HSN patients (above 150% up to 300% of poverty level) can be billed only up to their deductible. A patient approved for Medical Hardship cannot be pursued for more than their Medical Hardship contribution. Patients on MassHealth or EAEDC cannot be billed except for required copays and deductibles. Low Income Patients cannot be billed for medical errors or for claims their insurer denied because of an administrative or billing error.

Low Income Patients ... are exempt from Collection Action for any Reimbursable Health Services rendered by a Provider receiving payments from the Health Safety Net

Source, checked 2026-11-10

101 CMR 613.08 No liens on home or car without board approval

A hospital or its agent may not seek legal execution against the home or car of a Low Income Patient unless the hospital's Board of Trustees approves that one case.

must not seek legal execution against the personal residence or motor vehicle of a Low Income Patient ... without the express approval of the Provider's Board

Source, checked 2026-11-10

101 CMR 613.08 Deposits and interest-free payment plans

No deposit may be required before emergency care, or from Low Income Patients before treatment. For Low Income Patients a deposit is capped at 20% of the deductible, up to $500. For Medical Hardship patients it is capped at 20% of the contribution, up to $1,000. A balance of $1,000 or less must get at least a one-year interest-free plan with a monthly payment of no more than $25. A larger balance must get at least a two-year interest-free plan.

A Patient with a balance of $1,000 or less, after initial deposit, must be offered at least a one-year, interest-free payment plan

Source, checked 2026-11-10

101 CMR 613.08 Credit and Collection Policy filing and notices

Every acute hospital and health center paid by HSN must file a Credit and Collection Policy with the Health Safety Net Office, post it and its list of affiliated providers on its website, put a financial assistance notice on every bill and collection letter, and post signs in registration and emergency areas. Signs and notices must be translated into any language that is the primary language of 10% or more of residents in the service area.

Providers must make their Credit and Collection Policies ... and Provider Affiliate lists (if applicable) ... available on the Provider's website.

Source, checked 2026-11-10

105 CMR 95.00 Ban on reporting medical debt to credit bureaus (proposed)

A Department of Public Health regulation would bar every DPH-licensed health care facility and provider, including hospitals, from reporting any medical debt to a consumer reporting agency. Debt collector contracts signed on or after January 15, 2027 would have to include the ban, and older contracts running past April 15, 2027 would have to be amended by then. Violations would count as unfair practices under M.G.L. c. 93A. The text found on mass.gov is labeled a proposed regulation. Whether it is final was not confirmed.

No health care provider or health care facility shall report any portion of medical debt to a consumer reporting agency

Source, checked 2026-11-10