Delaware now requires nonprofit hospitals to offer free care to patients earning up to 300% of the federal poverty level, effective January 1, 2027. Senate Bill 13, signed by Governor Matt Meyer on July 21, 2026, sets this threshold—the highest statewide mandate in the United States.
For uninsured and underinsured residents regardless of employment status, this means hospital care at no cost if household income falls within the eligibility range. The law also creates a tiered discount structure for patients earning above that threshold and requires hospitals to screen all uninsured and self-pay patients by July 1, 2027. Governor Meyer signed SB 13 alongside two other healthcare bills as part of a three-bill affordability package.
Table of Contents
- What Income Qualifies for Free Hospital Care?
- How Do You Get Screened and Apply?
- What if My Income Is Higher than 300% of Poverty Level?
- Which Delaware Hospitals Must Offer This Assistance?
- When Does This Start and What Should You Know Now?
- Frequently Asked Questions
What Income Qualifies for Free Hospital Care?
For a family of three, 300% of the 2026 federal poverty level equals approximately $80,000 annually. The threshold applies to all medically necessary hospital inpatient and outpatient services—emergency care, surgery, imaging, lab work, and other essential treatments.
If your household income falls at or below this level, you qualify for free care regardless of whether you have insurance, are self-pay, or owe existing hospital debt. Federal poverty levels change yearly, so your eligibility recalculates each January. The threshold applies statewide across all nonprofit hospitals in Delaware and covers uninsured patients, underinsured patients (those whose insurance does not cover a procedure), and patients with outstanding hospital bills.
How Do You Get Screened and Apply?
By July 1, 2027, hospitals must screen all uninsured, self-pay, and patients owing $500 or more for financial assistance eligibility. Each hospital is required to distribute applications and maintain financial assistance policies that meet the new statewide standards. You do not need to wait for a bill to arrive or for the hospital to contact you—ask to be screened at registration or when receiving a bill.
When applying, be prepared to provide recent income documentation: pay stubs, tax returns, proof of unemployment, disability or Social Security income, or other evidence of household income. The hospital's financial assistance office will determine whether you qualify for free care, a discount, or a payment plan.
What if My Income Is Higher than 300% of Poverty Level?
Delaware's law creates a tiered discount structure for patients earning 300 to 400% of poverty level. If your household income falls between 300% and 350% of poverty level, you qualify for a 75% discount on medically necessary services. Those earning between 350% and 400% of poverty level receive a 50% discount. The law also requires all hospitals to maintain a medical hardship policy offering at least a 50% discount for patients up to 500% of poverty level when hospital bills exceed 10% of their household income. This addresses catastrophic medical expenses for middle-income families—if a single illness or injury threatens your financial stability, you may qualify even if your income exceeds the standard threshold.
Which Delaware Hospitals Must Offer This Assistance?
The charity care requirements apply to nonprofit hospitals statewide. Psychiatric hospitals, rehabilitative facilities, and long-term acute care hospitals are exempted from SB 13's financial assistance mandates. Before visiting an out-of-state hospital, confirm its charity care policies—this law covers Delaware facilities only. If you are unsure whether a hospital must follow these rules, ask the financial assistance office directly. The office staff can explain your facility's specific policies and walk you through the application process.
When Does This Start and What Should You Know Now?
The financial assistance standards take effect January 1, 2027, and hospitals must complete screening of eligible patients by July 1, 2027. In the months before implementation, hospitals are preparing systems, training staff, and distributing applications. Patients may begin applying in January 2027. If you have current hospital debt from care received before January 1, 2027, you can still apply for assistance.
Many hospitals will review retroactive eligibility for recent bills. Contact your hospital's billing department or financial assistance office to ask whether past-due balances qualify.
Frequently Asked Questions
Do I need to have a bill to apply for charity care?
No. Ask to be screened before or at the time of service. You can apply before a bill is generated.
Will using charity care affect my credit score?
Applying for financial assistance does not hurt your credit. However, an unpaid hospital bill reported to a credit agency does. Applying for assistance prevents the bill from reaching collections.
What counts as "medically necessary"?
Medically necessary services include emergency care, hospitalization, surgery, diagnostic tests, imaging, and other treatments a doctor determines are needed. Some elective procedures may not qualify.
What happens after the July 1, 2027 deadline?
All new uninsured, self-pay, and high-debt patients must be offered screening. Patients who applied before July 1 will continue under their approved assistance agreements.