Denver Hospital Discounted Care 2026–27: Colorado's HB 21-1198 Income Limit, 4% Payment Caps, 36-Month Forgiveness and Two-Level Appeals
Colorado's hospital discount law has a feature few other states offer: a built-in finish line. Under Hospital Discounted Care, created by House Bill 21-1198, qualifying patients pay their discounted hospital bill in monthly installments capped at a small share of income. Once they've made 36 monthly payments, whatever's left is forgiven.
For Denver patients facing bills from any Colorado general acute care hospital or freestanding ER, this guide covers who qualifies, what the caps mean in dollars, the deadlines hospitals must meet, and how to appeal. It's based on the Colorado Department of Health Care Policy and Financing (HCPF) patient pages.
Who Qualifies
According to HCPF:
Your gross household income must be 250% of the federal poverty guidelines or less.
You may qualify even if you are not a citizen, are an immigrant, or have health insurance.
The hospital will help you check whether you qualify.
HCPF publishes these approximate income limits:
Family size | Approximate annual income | Approximate monthly income |
1 | up to $39,900 | up to $3,325 |
2 | up to $54,100 | up to $4,508 |
3 | up to $68,300 | up to $5,692 |
4 | up to $82,500 | up to $6,875 |
5 | up to $96,700 | up to $8,058 |
6 | up to $110,900 | up to $9,242 |
7 | up to $125,100 | up to $10,425 |
8 | up to $139,300 | up to $11,608 |
HCPF lists its federal poverty guidelines for April 2026 through March 2027 on its Hospital Discounted Care page.
What Is Covered
HCPF says the program covers emergency and elective services at all Colorado general acute care and critical access hospitals and their off-campus locations, plus freestanding emergency departments. Services from licensed health care professionals, such as physicians, in those settings are also covered. Your eligibility determination covers professionals' services received while you were at the hospital.
The Three Protections If You Qualify
1. Your bill is capped at state-set rates. HCPF sets the allowed charges each year at the greater of the Medicare rate or the Medicaid base rate. Hospitals and physicians can't bill you more than Hospital Discounted Care allows.
2. Your monthly payments are capped by income.
Type of bill | Monthly payment cap |
Hospital (facility) bill | 4% of monthly household income |
Physician or professional bill | 2% of monthly household income |
A bill combining hospital and professional charges | 6% of monthly household income |
For example, if your household earns $3,000 a month, a hospital payment can't exceed $120 a month, and a physician's bill can't exceed $60 a month. If physicians bill separately, each can set up a plan using the physician amount. Your determination letter lists your exact maximum monthly payments.
3. Forgiveness after 36 payments. You don't owe any more after you make 36 monthly payments or pay the full discounted amount, whichever comes first.
Screening Rules: Uninsured vs. Insured
If you don't have health insurance:
The hospital must check whether you qualify for public coverage and discounts. That includes Health First Colorado (Medicaid), Child Health Plan Plus (CHP+), Emergency Medicaid and hospital discounts.
It must do so within 45 days of when you got care.
You can opt out of screening. But HCPF warns that if you refuse, you can't sue the hospital for not giving you discounts or not checking for programs.
If you have insurance:
You must ask the hospital to screen you.
The hospital then has 45 days to see whether you can get help.
Practical advice: if you're insured and have a large deductible or coinsurance bill, ask for Hospital Discounted Care screening in writing, and keep a copy.
How to Apply
Call the hospital's financial assistance or billing office. Say you want to be screened for Hospital Discounted Care. The number is on your bill or the hospital's website.
Complete the application. HCPF publishes a Uniform Application (Version 3.3, effective April 1, 2026) that hospitals use.
Provide income information for your household. The hospital will tell you what it needs.
Watch for your determination. The hospital must tell you whether you qualify within 21 days of your completed application.
Check the letter. It should show your maximum monthly payments. Compare them with the 4%, 2% and 6% caps above.
A Worked Example
Suppose a family of three earns $4,500 a month, below HCPF's approximate limit of $5,692. After an ER visit, they receive a discounted hospital bill and a separate emergency physician bill. Under the caps:
The hospital plan can't exceed 4% of income, which is $180 a month.
The physician plan can't exceed 2%, which is $90 a month.
If the discounted balance is still unpaid after 36 monthly payments, the rest is forgiven. The actual discounted charge depends on HCPF's annual rates for the services received. Check your determination letter for your exact figures.
No Insurance Going Forward?
HCPF notes that uninsured patients may qualify for financial help buying coverage through Connect for Health Colorado, during open enrollment or after a qualifying life event. Getting covered can prevent the next bill. The hospital's screening for Health First Colorado or CHP+ may also cover past care.
Your Rights to Information
Since September 1, 2022, hospitals must tell all patients about their rights under Hospital Discounted Care:
on the hospital's website,
in waiting rooms,
explained at the hospital in your preferred language, and
included in bills.
If you didn't get the Patient Rights information, you can file a complaint with HCPF.
Before Collections: What the Biller Must Do
Before sending your bill to collections, the biller must:
complete the screening steps above,
explain all services and fees on your bill in your preferred language,
bill your insurance first, before setting up a payment plan, and
notify you in writing 30 days before sending you to collections.
If your bill goes to collections without these steps, HCPF says you can file a complaint and may also take legal action.
If You're Denied: Two Levels of Appeal
Level 1: the hospital.
You can appeal if the hospital found you ineligible and you think you qualify, or if it found you eligible but used wrong information, so your amount should be lower.
Ask the hospital in writing to check your case for mistakes.
File within 30 days of the date the hospital gave you its decision.
The hospital must give you instructions for appealing and must acknowledge your appeal within three business days.
If you're having trouble filing with the hospital, you can also appeal to HCPF by email.
Level 2: HCPF.
If the hospital doesn't change its decision, you can file a second appeal with HCPF at hcpf_HospDiscountCare@state.co.us.
Send it within 15 calendar days of the hospital's appeal decision.
If HCPF finds you eligible, the hospital must send a new determination letter and discount your bills. HCPF's decision is final.
Appeal checklist: your determination letter, proof of household income and size, and a short statement of what was wrong.
Complaints
You can complain about poor communication from the financial assistance office, bills that weren't properly discounted, missing or late paperwork, or not getting the Patient Rights document.
First, call the hospital billing department. HCPF says it can't change bills itself, but it can help get a bill corrected if you qualified and weren't discounted.
HCPF Hospital Discounted Care: 303-866-2580 or hcpf_HospDiscountCare@state.co.us.
More Help
More help in Denver: Denver financial help guides
Related Guides
Sources
This guide gives general information, not legal advice. Confirm details with your hospital's financial assistance office or HCPF.
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