Mayo Clinic must now provide free charity care automatically to patients with household incomes up to 200% of the federal poverty guideline, without requiring a completed financial application, under a settlement agreement reached with Minnesota's attorney general in March 2025. The health system also agreed to strict limits on suing patients for unpaid medical debt and to offer 40–50% discounted care to those earning up to 400% of the poverty guideline. The settlement resolves a multiyear investigation triggered by reporting that Mayo had pursued legal action against patients who actually qualified for financial assistance. The agreement requires Mayo to screen patients for eligibility upfront, instead of waiting for them to complete a lengthy financial application first.
Official resources:
- Check eligibility on Mn’s official study page — Use this page to check the study’s participation requirements.
- Apply through Mn’s official page — Use this page to review requirements and apply directly.
Table of Contents
- What "Presumptively Eligible" Means
- Free Care, Discounted Care—and Who Qualifies
- Mayo Cannot Sue Most Patients for Medical Debt
- Important Limitations and Geographic Scope
- What to Do If You Received a Bill from Mayo
- Frequently Asked Questions
What "Presumptively Eligible" Means
"Presumptively eligible" is Mayo's term for patients whose income level alone qualifies them for charity care, without paperwork. In the October 2023–August 2024 period, $89 million of $142 million in total financial assistance went to patients who never submitted a financial application—meaning many patients who qualified were still being billed before the settlement, because Mayo required them to apply first.
Under the new settlement, Mayo must identify these patients before sending a bill. The health system will use income screening during registration or at the time of care to flag patients who likely qualify, then automatically apply charity care discounts without making them fill out forms.
Free Care, Discounted Care—and Who Qualifies
The settlement specifies that Mayo Clinic must offer free charity care to patients with household incomes up to 200% of the federal poverty guideline, and 40–50% discounted rates for those earning 200–400% of poverty. Patients above 400% of the poverty guideline may still qualify for additional discounts or extended payment plans depending on their circumstances. The key change is that Mayo can no longer require you to prove your income with tax returns or paystubs before automatically extending the discount. Patients in these income ranges should receive financial help based on information Mayo gathers during registration.
Mayo Cannot Sue Most Patients for Medical Debt
The settlement prohibits Mayo Clinic from suing patients to collect medical debt except in "extraordinary circumstances," and the health system's chief financial officer must approve every lawsuit before it is filed. This restriction directly addresses the December 2022 reporting that triggered the investigation: Mayo had sued patients for unpaid bills even when they qualified for free or discounted care. The requirement for CFO-level approval adds a human review step before any legal action, making it unlikely that qualifying patients will face lawsuits over medical debt in the future.
Important Limitations and Geographic Scope
The settlement applies to Mayo Clinic's operations under Minnesota law; scope for Mayo Clinic's operations outside Minnesota may vary. Patients treated at Mayo locations outside Minnesota, or by affiliated providers in other states, may not have the same protections. The settlement includes no financial penalty to Mayo and no admission of wrongdoing by the health system, though the attorney general's investigation found problems with how Mayo applied its existing charity care policies. The agreement is binding and enforceable, but it does not automatically reverse bills collected or lawsuits filed before March 2025.
What to Do If You Received a Bill from Mayo
If you received a bill from Mayo Clinic for care in Minnesota and believe your household income qualifies for financial help, contact Mayo's financial assistance office to request review. Bring recent pay stubs or tax returns as proof of income, or ask whether Mayo will screen you based on information already in their system. If Mayo sued you or placed your account with a debt collector before the March 2025 settlement took effect, document the dates and amounts. You can report this to the Minnesota Attorney General's office, which may investigate individual cases as part of its ongoing oversight of the settlement.
Frequently Asked Questions
Do I have to apply for charity care, or does Mayo find me automatically?
Under the settlement, Mayo must screen patients for eligibility during registration and apply charity care automatically without requiring a completed financial application. However, you should contact Mayo's financial assistance office directly to ensure you are reviewed if you believe you qualify.
What if Mayo already sued me for a bill before this settlement?
The March 2025 settlement does not automatically reverse prior collections. If you were sued before the settlement took effect, contact the Minnesota Attorney General's office to report it and request investigation.