VCU Health Financial Assistance: How Richmond Patients Get Free or Discounted Care
If you got care at VCU Medical Center, the Children's Hospital of Richmond at VCU or another VCU Health site and the bill is more than you can handle, the health system's financial assistance policy can cut it sharply or erase it. Under the current policy, effective March 19, 2026, households at or below 200% of the federal poverty level can have the whole bill written off, and discounts reach households well above that. Here's how the tiers work, the asset test that trips people up, and how to apply before the 240-day window closes.
QUICK FACTS
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Who the policy covers
VCU Health's Financial Assistance policy applies to VCU Health System Authority and its affiliates, including:
VCU Medical Center (including the Virginia Treatment Center for Children and pediatric outpatient surgery)
Community Memorial Hospital (CMH)
VCU Health Tappahannock Hospital
VCU Health Ambulatory Surgery Center
VCU Health Children's Services at Brook Road
MCV Physicians and CMH Physician Services
The policy is for emergency or medically necessary care. VCU Health says it treats emergency medical conditions without discrimination, whether or not you qualify for help.
What isn't covered
Read this part before you assume every bill is included. The policy doesn't apply to independent physicians or contractors who bill separately. It also lists a long set of specialties, from anesthesiology and emergency to oncology, radiology and surgery, that are excluded if the care wasn't provided by an MCV Physicians provider. If you get a separate bill from a physician group, ask who the provider works for.
VCU Health's retail pharmacy isn't covered either, but the policy says it may offer discounts if you show an approval letter for indigent care.
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Two programs stacked together
VCU Health's discount comes from two layers, and most qualifying patients get both:
State University Teaching Hospitals Indigent Care. This is Virginia's state-sponsored program for people who lack resources or have used up their insurance. It covers households at or below 200% of FPL who pass an asset test.
VCUHS-funded Charity Care. This is VCU Health's own discount. It covers households at or below 300% of FPL with no more than $5,000 in liquid assets per household member.
The policy calls patients who qualify for both "dual eligible." Appendix A of the policy shows how the two stack:
Household income (% of FPL) | State Indigent Care discount | VCU Health Charity discount | Total discount |
|---|---|---|---|
0–100% | 100% | 0% | 100% |
101–110% | 95% | 5% | 100% |
111–133% | 80% | 20% | 100% |
134–166% | 55% | 45% | 100% |
167–200% | 30% | 70% | 100% |
201–300% | 0% | 86% | 86% |
Over 300% | 0% | 55% | 55% |
So anyone at or below 200% of FPL who qualifies ends up with a 100% discount, while someone between 201% and 300% pays 14% of the bill. The chart shows a 55% discount above 300%. The policy text describes VCU Health Charity Care only up to 300%, so ask a financial counselor how that top tier applies to you.
FPL figures are set by the U.S. Department of Health and Human Services and change each year. VCU Health says it updates its criteria when the federal guidelines change.
The asset test
State Indigent Care has strict asset limits. Patients with assets above these amounts may not qualify, regardless of income:
Household size | Asset limit |
|---|---|
1 person | $2,000 |
2 people | $3,000 |
3 people | $3,100 |
Each additional person | add $100 |
"Assets" is broad. It includes cash, bank balances, stocks and bonds, trust funds, personal injury claims, cash value of life insurance, mortgages owed to you, the value of any vehicles beyond one per household (unless needed for self-employment), and real estate other than your home and up to 3.99 contiguous acres.
If your savings are over the limit, you may still qualify for the VCU Health Charity layer, which uses the $5,000-per-person liquid asset limit instead.
VCUHS provides care for emergency medical conditions without discrimination to individuals, regardless of their eligibility for help under this financial assistance policy. (VCU Health Financial Assistance policy, effective March 19, 2026)
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Ways to get help without a full application
Presumptive charity. VCU Health can approve 100% charity without income or asset paperwork, or even an application, based on your circumstances. Examples in the policy include:
income at or below 200% of FPL while uninsured (self-pay)
being homeless or getting care at a homeless clinic
eligibility for SNAP, school lunch, subsidized housing or WIC
qualifying for state-funded medication programs
eligibility for an unfunded state or local program, like Medicaid spend-down
a referral from the Ledwith-Lewis Free Clinic
being sent to a skilled nursing facility, or the patient having died
certain Medicaid situations, such as becoming Medicaid-eligible after the service
The policy says VCU Health may use outside data, such as a credit score, to decide presumptive eligibility.
Catastrophic bills. If you don't qualify for Indigent Care but your related medical bills are more than 25% of household income and you can't pay, VCU Health may still help. These requests are case by case and depend on budget.
Non-emergency care you can't afford. For costly medically necessary care that isn't an emergency, the policy requires a referral, either through one of VCU Health's collaborating patient help programs with an MCV Physicians doctor advocating, or directly from an MCV Physicians doctor. Administration reviews each request.
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How to apply
VCU Health's application (revised April 2026) asks for:
a driver's license or state photo ID for you and your spouse, or other proof of residency
the completed financial statement page listing household members, income and assets
proof of income for the three full months before you apply
Accepted income proof includes your last three consecutive pay stubs, last year's W-2, a recent TANF or General Relief letter, your Social Security award letter, child support records, recent bank statements, retirement income records, a termination letter, last year's Schedule C and 1040 if you're self-employed, or a letter explaining you have no income and how you're covering expenses. VCU Health may ask for more asset proof.
How to send it | Details |
|---|---|
Online | Log in to VCU Health MyChart at mychart.vcuhealth.org |
VCU Health Public Benefits Department, PO Box 718997, Philadelphia, PA 19171-8977 | |
Fax | 804-828-2029 |
VCUHealthfinancialassistance@ensemblehp.com | |
Phone help | 804-828-0966, Monday to Friday, 9 a.m. to 4 p.m. |
Financial counselors can help you fill out the form, apply for Medicaid or other coverage, and renew coverage. Trained certified application counselors can also help with the Health Insurance Marketplace.
STEPS TO GET A VCU HEALTH BILL REDUCED
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What happens to collections
The policy has several protections for people who apply:
Collections pause. Collection activity stops once VCU Health receives your application and stays paused until it approves or denies you. No extraordinary collection action happens before a written decision.
Timeline. VCU Health makes "all reasonable efforts" to decide within 30 days, though it may ask for more information.
Statement cycle. Bills go out on day 1, day 28 and day 56. The third statement warns that the account may go to collections, and accounts can be sent to a collection agency at day 122.
120-day rule. VCU Health won't take extraordinary steps, such as using a collection agency, credit reporting or legal action, within 120 days of the first bill without first making reasonable efforts to see whether you qualify for help.
Retroactive credit. Once approved, the discount applies to self-pay accounts that haven't gone to an outside collection agency. That's another reason to apply before day 122.
In an October 2019 announcement, VCU Health said it had stopped sending patient accounts to court as part of routine collection and stopped issuing new wage garnishments or home liens. The current policy still lists legal action among possible extraordinary collection steps, so don't ignore bills.
Approval and renewal
Approval for Indigent Care lasts 12 months from the date you filed the application. You can reapply after 12 months. The application form says the help applies to open balances where the first bill was within 240 days of your application.
At Community Memorial Hospital, VCU Health Tappahannock Hospital and the ambulatory surgery center, patients who qualify can't be charged more than the "amount generally billed" to Medicare patients. You can get a free paper copy of that calculation from Fiscal Services at 434-447-3151.
If you don't qualify
Payment plans. VCU Health says it can work with you on a manageable payment plan. Call billing customer service at 888-803-0082 for VCU Medical Center, MCV Physicians or CMH bills.
Financing. VCU Health also offers ClearBalance, a zero-interest revolving credit account from Republic Bank & Trust with no credit check (888-803-0082). It's still a credit account, so compare it with a plain payment plan first.
Insurance help. For help choosing a Health Insurance Marketplace plan, VCU Health refers patients to the Virginia Insurance Counseling and Assistance Program at 1-800-552-3402.
VCU Health's older Virginia Coordinated Care program for uninsured patients ended October 31, 2019, after most members became eligible for Medicaid. VCU Health said patients who don't qualify for Medicaid can still use VCU Health and Central Virginia's free clinics and health centers.
Related guides
Official sources
Last checked: October 30, 2026. Facts come from VCU Health's financial assistance page, its March 2026 policy and April 2026 application, its billing and coverage pages, and two 2019 VCU Health announcements.
Discounts depend on VCU Health's review of your household income and assets. Confirm your eligibility and deadlines with the Financial Counseling Call Center at 804-828-0966.
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