NYC Hospital Bill Help 2026–27: NYC Care, H+H Options, the New Sliding Fee Scale and Your Rights at Private Hospitals
If you live in New York City and you're uninsured, underinsured or staring at a hospital bill you can't pay, two things work in your favor. First, the city's public hospital system, NYC Health + Hospitals, runs two discount programs, NYC Care and H+H Options. Under both, fees start at $0. Second, a state law that got much stronger in October 2024 now requires every hospital licensed by the New York State Department of Health to offer financial aid, private hospitals included, to households earning up to 400% of the federal poverty level.
This guide covers both. You'll see what the public system charges at each income level, who qualifies for NYC Care versus Options, what to bring, and the rules that protect you at hospitals like Mount Sinai, NYU Langone or NewYork-Presbyterian. It also explains what to do if you're denied.
Last checked October 2026. Sources: the NYC Care website and FAQ, ACCESS NYC's NYC Care page (updated April 27, 2026), NYC Health + Hospitals' Financial Assistance Sliding Fee Scale Table (effective April 1, 2026), the NYC H+H Financial Assistance Policies and Procedures, and the New York Attorney General's hospital financial assistance guide. Hospital policies change, so confirm the details with a financial counselor before you rely on them.
The Short Version
Public hospitals (NYC Health + Hospitals): If your household income is at or below 200% of the federal poverty level, you get a 100% discount. That's under $66,000 a year for a family of four. Between 201% and 500%, you pay fixed, reduced fees such as $20 to $50 for a clinic visit.
NYC Care is for New Yorkers in the five boroughs who can't get or can't afford health insurance. It has no membership fees, monthly fees or premiums, and it doesn't ask about immigration status.
H+H Options uses the same fee scale for people who don't qualify for NYC Care, including some visitors and residents of Nassau and Westchester counties.
Every other hospital in New York State must offer financial aid up to 400% of the poverty level and waive all charges below 200%. Payment plans can't take more than 5% of your monthly income or charge more than 2% interest.
There's no deadline. You can apply for financial aid even after a bill has gone overdue.
Phone numbers: NYC Care at 646-NYC-CARE (646-692-2273). Community Health Advocates, the state-funded helper for hospital aid applications, at 888-614-5400.
Option 1: NYC Care
NYC Care isn't insurance. NYC Care calls itself "a health care access program that guarantees low-cost and no-cost services to New Yorkers who do not qualify for or cannot afford health insurance." All services are delivered through NYC Health + Hospitals, and members can use any of its patient care locations in the five boroughs. According to the program's FAQ, that includes 11 hospitals and dozens of community health centers.
As a member you get a membership card and your own primary care provider, plus access to affordable medications. Covered services listed on the NYC Care site include:
Primary and preventive care
Women's health
Medications, available 24/7
Eye care and eyeglass prescriptions
Specialty care
Mental health care
Treatment for alcohol, tobacco and substance use
Support services for housing, food and nutrition
Who qualifies
According to ACCESS NYC, you qualify for NYC Care if you:
Live in New York City (any of the five boroughs)
Don't have health insurance through an employer
Don't qualify for any health insurance plan available in New York State
Can't afford health insurance under government guidelines
Immigration status doesn't matter. NYC Care says it doesn't ask about immigration status, and the FAQ adds that NYC Health + Hospitals doesn't record that information.
What it costs
Fees are set by your family size and income and start at $0. There are no membership fees, monthly fees or premiums. The actual amounts follow the system-wide sliding fee scale shown below.
How to enroll
You can enroll in any of these ways:
Call 646-NYC-CARE (646-692-2273)
Visit an NYC Health + Hospitals location
Visit a community-based partner organization
Visit a MetroPlusHealth office
What to bring: proof of identity, New York City residency, household income and household size. If you've already been screened for insurance through the NY State of Health Marketplace, ACCESS NYC says you can bring a printout of that determination instead of more paperwork. If you're missing documents, a counselor may still be able to help, so call before you give up.
If you're already in the H+H Options program and were screened for insurance in the last six months, ask about faster enrollment.
Renewing
Your membership lasts up to 12 months. The FAQ says a financial counselor will rescreen you every year, first checking whether you now qualify for insurance. You can renew up to 30 days before the "effective through" date printed on your card. Have the same documents you used to enroll.
Option 2: H+H Options
Options is NYC Health + Hospitals' other financial assistance program, and it uses the same fee scale. NYC Health + Hospitals' financial assistance policy describes Options as the program for people who aren't eligible for insurance or can't afford it but don't meet NYC Care's rules, including many visitors to New York City. The policy also says patients and visitors from Westchester and Nassau counties can use Options at any NYC Health + Hospitals facility.
The system's financial assistance policy describes several situations where Options can apply even if you don't meet NYC Care's city-residency rule. Examples include emergency treatment for New York State residents and for visitors who can show proof of their visit. Options can also cover urgent care or an already-scheduled appointment when you've enrolled in insurance that hasn't started yet and won't pay retroactively.
The easiest way to figure out which program fits you is to sit down with a financial counselor at any NYC Health + Hospitals facility.
What You'll Pay: The 2026 Sliding Fee Scale
Here are the household income cutoffs from NYC Health + Hospitals' sliding fee scale, effective April 1, 2026:
| Household size | 200% FPL (free care) | 300% FPL | 400% FPL | 500% FPL (scale ends) | |---|---|---|---|---| | 1 | $31,920 | $47,880 | $63,840 | $79,800 | | 2 | $43,280 | $64,920 | $86,560 | $108,200 | | 3 | $54,640 | $81,960 | $109,280 | $136,600 | | 4 | $66,000 | $99,000 | $132,000 | $165,000 | | 5 | $77,360 | $116,040 | $154,720 | $193,400 | | 6 | $88,720 | $133,080 | $177,440 | $221,800 |
And here's what each service costs at each income band:
| Service | Up to 200% | 201–250% | 251–300% | 301–350% | 351–400% | 401–500% | |---|---|---|---|---|---|---| | Medical clinic visit | $0 | $20 | $20 | $30 | $40 | $50 | | Behavioral health visit | $0 | $15 | $20 | $30 | $40 | $50 | | Vaccine-only visit | $0 | $0 | $0 | $0 | $0 | $0 | | Emergency room visit | $0 | $30 | $30 | $60 | $60 | $100 | | Prescription (each) | $0 | $3 | $3 | $6 | $6 | $20 | | Ambulatory surgery | $0 | $200 | $200 | $450 | $450 | $650 | | MRI | $0 | $50 | $50 | $100 | $100 | $150 | | Inpatient stay | $0 | $150 | $400 | $900 | $1,200 | $1,500 |
If you have insurance with co-pays, coinsurance or deductibles you can't manage, the same table caps your share. You pay 10%, 20% or 30% of your normal cost share depending on your income band, and nothing at or below 200%. Above 500% of the poverty level, you're charged the system's self-pay rate.
More protections in the public system's policy
NYC Health + Hospitals' Financial Assistance Policies and Procedures also says:
No one is turned away from medically necessary care because of an unpaid bill.
Deposits can't be more than 10% of your gross monthly income, and scheduling can't wait on a deposit.
Payment plans can't take more than 5% of your gross monthly household income each month.
You don't have to pay while your insurance or financial assistance application is pending, once you've submitted a complete application with documents.
You'll get a written decision within 30 days of a completed application.
If you're denied, you'll receive a Notice of Appeal form, and you have 30 days to return it with supporting documents.
If you need ongoing treatment for a chronic condition, your physician can write a "statement of need," and you'll then be charged no more than once a month for that care.
If you truly can't pay even the reduced fee, ask about a fee waiver. A physician decides whether waiving it is needed for your care to continue.
At Private and Nonprofit Hospitals: Your Rights Under State Law
Plenty of New Yorkers end up at a hospital outside the public system. The New York Attorney General's guide explains that the Hospital Financial Aid Law (Public Health Law section 2807-k(9-a)) requires all hospitals in the state to run financial aid programs.
Who qualifies: In most cases, households with income up to 400% of the federal poverty level, which is about $132,000 for a family of four. You also have to fit one of these:
You have no health insurance.
You're underinsured, meaning your out-of-pocket medical costs in the past year (not counting premiums) were more than 10% of your pre-tax household income.
You've used up your insurance benefits and can show you can't pay the rest.
What you'll pay:
| Household income | Uninsured | Underinsured | |---|---|---| | Under 200% FPL | All charges waived | All charges waived | | 200–300% FPL | Up to 10% of what Medicaid would pay | Up to 10% of your insurance cost share | | 301–400% FPL | Up to 20% of what Medicaid would pay | Up to 20% of your insurance cost share |
Key rules from the Attorney General's guide:
Emergency care must be covered for every eligible New Yorker. For non-emergency care, a hospital only has to cover patients who live in its primary service area, which it defines in its written policy summary.
Every hospital uses the same state application, which you can download from the Department of Health website or get from the hospital's billing office.
A hospital can't ask about assets like your home or car. It also can't deny you just because you don't have a specific document, such as bank statements or tax returns.
Hospitals can't consider immigration status. Applying doesn't count as a public benefit.
You get a decision within 30 days, and you can appeal a denial or ask for a larger discount.
While your application is being reviewed, a hospital can't send your bill to a debt collector. Even if you never apply, it has to wait at least six months after your first bill.
If you think a hospital broke these rules, call the Attorney General's Health Care Bureau helpline at 1-800-428-9071.
Quick Checklist
Ask for a financial counselor before you leave the hospital, or as soon as the bill arrives.
Gather your documents: ID, proof of address, pay stubs or a benefits letter (or a signed statement of no income), and proof of household size.
Apply even if the bill is old. Neither the public system nor state law sets a deadline.
Stop paying while you wait, once your application is complete, and keep a copy of everything you submit.
Read your decision letter. If you disagree, appeal within the time it gives you. That's 30 days in the public system.
Get free help from Community Health Advocates at 888-614-5400.
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