Austin Hospital Bills: Start With Central Health MAP, Then Ask the Hospital for Help
If you're uninsured in Austin and a hospital bill is on the way or already in your mailbox, two local doors matter most. One is Central Health's Medical Access Program (MAP), which is the county's own coverage program. The other is the financial assistance policy at the hospital that treated you. This guide covers both, in the order most people should try them, with the income limits, phone numbers and deadlines from each program's own pages.
AT A GLANCE
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Why the order matters
A hospital financial assistance application deals with one bill, or one stretch of care. MAP is different. It's ongoing coverage through Central Health, the Travis County Healthcare District, and it connects members to doctors, dentists, pharmacies and specialists. Its covered services list includes hospital services, imaging, labs and urgent care.
So if you live in Travis County and you're uninsured, MAP is usually the first call. It can help with the care you still need. Then, for a bill you already have, you can apply to the hospital's own program. Ascension Seton's policy, for example, says uninsured patients must work with a financial counselor to apply for Medicaid or other public programs they may qualify for, unless they're approved through presumptive scoring.
Central Health is clear about what MAP is not. Its page says MAP and MAP Basic "are not health insurance programs, and they are not federally funded."
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Step one: Central Health's MAP
Who qualifies
MAP eligibility depends on the income you received in the last 30 days. Uninsured Travis County residents with income at or below 200% FPL qualify for MAP or MAP Basic if they meet the other rules. Central Health lists these monthly limits:
Family size | Monthly income limit (200% FPL) |
|---|---|
1 | $2,660.00 |
2 | $3,607.07 |
3 | $4,554.00 |
4 | $5,500.00 |
Central Health says these are based on FY 2026 poverty levels and are updated each year on March 1. For MAP, your household is you, your spouse and your children under 18 who live with you.
Documents to gather
You need at least one document from each category that applies to you:
Travis County residence: a lease, a current utility bill or postmarked mail from the last 30 days. If you don't have those, there are forms for this: the Residence and Financial Support form, the Applicant Residency Statement and the Landlord Statement.
Picture ID (adults): a driver's license or state ID, an Austin Public Library photo ID card, a foreign ID or passport, or a Service Point card.
U.S. citizenship or residency for household members, if it applies: a birth certificate, a Legal Permanent Resident card or a passport.
Monthly household income: check stubs from the last 30 days, a current-year retirement or Social Security benefits letter, or self-employment records. If you have no income, use the Zero-Income Statement. For cash income with no taxes taken out, there's a separate form.
Other health coverage, if anyone in the household has it: a Medicaid, Medicare or private insurance card.
Household size: birth certificates, adult picture IDs or legal guardianship papers.
Three ways to apply
Online. Use the application link on Central Health's MAP page. Central Health recommends Chrome, Edge or Safari. You can use the same link later to send more proof documents.
By phone or in person. Call 512.978.8130, option 1, Monday through Friday, 8 a.m. to 5 p.m. You can apply over the phone or book an in-person appointment. If you speak a language other than English or Spanish, tell the team member and they'll get an interpreter. Relay Texas users can dial 711.
By mail. Print the MAP application and the Applicant Responsibilities form, then mail them with your documents to Medical Access Program, PO Box 300489, Austin, TX 78703.
Someone helping you apply? They'll need Central Health's Authorization Form.
MAP isn't insurance, but for an uninsured Travis County resident it's often the difference between paying for every visit and having a doctor, a pharmacy and a plan.
After you're approved
See a primary care provider soon. Central Health says to call the clinic number on your membership card and book a new-patient visit as soon as you can. It warns that getting in as a new patient "may take a couple of months."
Bring your card and a photo ID to every visit and every pharmacy pickup. Only you can use your card. Central Health says you could lose services if you let someone else use it.
Prescriptions have a copay of up to $30, depending on your plan. Your card shows the exact amount on the "RX" line. For help with prescriptions, call the Pharmacy Helpline at 512-978-8139.
Not sure whether to go to the ER? During business hours, call the number on your card to talk with a nurse. After hours, call 512.978.8130, option 2. In an emergency, call 911.
Renew on time. MAP cards renew every 6 months and MAP Basic cards every 12 months. Central Health suggests starting 30 to 45 days before the expiration date shown next to "EXP" on your card.
If you don't qualify for MAP
CommUnityCare health centers charge on a sliding fee scale based on income and family size, and Central Health lists other sliding-fee clinics too:
Clinic | Phone |
|---|---|
CommUnityCare | 512.978.9015 |
Lone Star Circle of Care | 512.686.0534 |
People's Community Clinic | 512.478.4939 |
If you live just outside Travis County, Central Health points to these county programs: WilCo Care (Williamson County) at 512.248.3252, Hays County Indigent Health Care at 512.393.5520 and Bastrop County Indigent Health Care at 512.581.7170. For help in person, call 2-1-1 in Travis County.
Open enrollment for Marketplace health plans starts November 1. Central Health says to enroll by December 15 for coverage as early as January 1, and 2-1-1 can connect you with free enrollment help.
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Step two: the hospital's own financial assistance
Whether or not you get MAP, ask the hospital about its financial assistance policy (FAP) for any bill from emergency or medically necessary care. The two systems below set their rules differently:
Ascension Seton | St. David's HealthCare | |
|---|---|---|
Free care (100%) | Income up to 250% FPL | In most cases, income up to 200% of the poverty guidelines |
Partial help | 95% off at 251–300% FPL, 90% at 301–350%, 85% at 351–400% | 40% to 90% off for income above 200% and up to 500%, if what you owe is more than 10% of yearly income |
Very large bills | "Means test" above 400% FPL when total medical debt equals or exceeds household gross income | "Catastrophic" help that lowers the balance to 10% to 40% of income |
Phone | 512-324-1125 or 800-749-7624 | The number for your hospital (see below) |
Ascension Seton
Ascension Seton's policy covers Dell Seton Medical Center at The University of Texas, Dell Children's Medical Center, Ascension Seton Medical Center Austin, and its Northwest, Southwest, Cedar Park, Williamson, Hays and other Central Texas hospitals. Here are the details that matter most:
Where you live counts. Help goes to patients in Ascension Seton's "Community." For the Austin area, that's Travis County, plus surrounding counties like Hays, Williamson and Bastrop.
The 240-day line. Apply within 240 days of your first bill after discharge, and you can get the full discount. If you apply after that, the help is limited to the balance you still owe once your payments are counted.
A possible small fee. Eligible patients may be charged a nominal flat fee of up to $30 for services.
Assets can matter. The policy includes an asset test. Patients with assets above a set threshold may not qualify.
Apply online from Ascension Seton's financial assistance page, or ask for an application in Patient Access at any facility. The policy says an application is considered for up to six months.
Appeals are short. If you're denied, you have 14 calendar days from the denial notice to send more information. Mail a written appeal with documents to Patient Financial Services, P.O. Box 204301, Dallas, TX 75320-4301.
Behavioral health costs? Call 512-324-2039 to schedule a no-cost assessment with a navigator.
St. David's HealthCare
St. David's policy covers St. David's Medical Center, North Austin, South Austin, Round Rock and Georgetown, along with Heart Hospital of Austin, St. David's Surgical Hospital and its rehabilitation hospital. A few things set it apart:
You must fill out the St. David's application. The hospital may also verify income electronically through an outside vendor.
Income proof can be a W-2, pay stubs, tax returns, bank statements, Social Security or unemployment notices, or a phone check with your employer. Proof that you're in a program like Medicaid, CHIP, food stamps or WIC also counts, and you send it with the application.
It lasts 12 months. After a year, you'll need a new application and new documents.
Phones by hospital: St. David's Medical Center 866-391-2021, North Austin 866-391-2015, South Austin 866-391-2018, Round Rock 866-391-2017, Georgetown 866-396-1025, Heart Hospital of Austin 866-291-3547, Surgical Hospital 855-890-3304.
Mail: Patient Account Services, PO Box 292369, Nashville, TN 37229-2369.
If you qualify at either system, you can't be charged more for emergency or medically necessary care than the hospital's "amounts generally billed" to insured patients.
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Federal timelines that protect you
These IRS rules apply to nonprofit hospitals that follow Section 501(r). Both systems say their policies are written to meet those rules.
Rule | What it means for you |
|---|---|
120-day notification period | The hospital generally can't start "extraordinary collection actions" until 120 days after your first post-discharge bill. |
240-day application period | You can apply for financial assistance for at least 240 days from that first bill. |
30-day written notice | Before any extraordinary collection action, the hospital must send written notice at least 30 days ahead. |
How to work a bill, step by step
Get an itemized bill and find the date of the first statement after discharge.
If you live in Travis County and you're uninsured, apply for MAP. If you get a bill for care you had while on MAP, call option 3.
Call the hospital's financial assistance line, ask for the application and ask whether your account can be put on hold while it's reviewed.
Send your proof together, including income, household size and any benefit letters. Keep copies.
Get the decision in writing. If you're denied at Ascension Seton, appeal within 14 days.
For anything left, ask about the uninsured discount and prompt-pay discount (Ascension Seton lists both) before agreeing to a payment plan.
Before you call
☐ Your account number and the date on your first post-discharge bill
☐ Your household income for the last 30 days (for MAP) and for the year (for hospital applications)
☐ A photo ID and proof that you live in Travis County
☐ Any Medicaid, CHIP, SNAP or other benefit letters
☐ Your MAP card, if you have one
☐ A notebook for names, dates and reference numbers
WHAT TO DO THIS WEEK
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More help in Austin
Related guides
Official sources
Last checked: October 23, 2026. MAP income limits are Central Health's FY 2026 figures, updated each March 1. Hospital terms are from Ascension Seton's July 1, 2025 policy and St. David's posted policy and summary. Federal timelines are from the IRS 501(r)(6) page.
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