Medical Hardship Grants Texas: Charity Care, County Programs, and Other Help With Medical Bills

How medical hardship grants Texas residents get really work

When people search for a medical hardship grant, they often picture a check that pays the hospital. Those exist, but they are small and limited. Most real help in Texas works in one of three ways:

• The bill is reduced or erased through a hospital’s charity care or a county program.
• Coverage pays the bill when you qualify for Medicaid, CHIP, or another health program, sometimes for past months.
• A foundation pays part of the cost of a specific disease, such as copays, premiums, or drugs.

The order matters. Charity care and coverage usually save the most money, so apply for them first. Then use foundations and local charities to fill the gaps. For more on grants outside of health care, see our guide to hardship grants for individuals.

Hospital charity care and financial assistance

Nonprofit hospitals are the most important place to start. Under federal tax rules in section 501(r), each nonprofit hospital must have a written financial assistance policy. The policy must explain who qualifies for free or discounted care, how to apply, and what collection steps the hospital may take. The hospital must post the policy, the application, and a plain-language summary online, and give free paper copies on request.

Federal rules also limit what eligible patients pay and how quickly the hospital can collect:

• Price limit: patients who qualify cannot be charged more than the amount generally billed to insured patients for emergency or medically necessary care, according to the IRS limitation on charges rule.
• Time to apply: you can apply during the 240 days that begin with the first bill after discharge.
• No fast collections: the hospital cannot start “extraordinary collection actions,” like credit reporting, lawsuits, liens, or selling your debt, until at least 120 days after that first bill, and it must give you 30 days’ written notice first.
• Pause while you apply: once you turn in a complete application, these collection actions must stop until the hospital decides.

These rules come from the IRS billing and collections rule. Income limits for charity care are set by each hospital, so ask for the policy and read it. Public and for-profit hospitals are not covered by 501(r), but many still offer discounts. Our guide on paying a hospital bill without insurance has a script for that call.

County Indigent Health Care Program

Texas counties, hospital districts, and public hospitals run the County Indigent Health Care Program (CIHCP) for residents who cannot get Medicaid. According to Texas Health and Human Services, to qualify you must:

• Live in Texas, in the county where you apply.
• Have income at or below 21% of the federal poverty guidelines.
• Have resources under $2,000.
• Not be eligible for Medicaid.

The 21% figure is the state minimum. Some counties and hospital districts choose higher income limits, so ask your county even if your income is a little above it. Covered services can include doctor visits, hospital care, lab work, X-rays, vaccines, screenings, and yearly exams. Counties may limit how much they pay per person each year, so ask about any cap.

To apply, contact the indigent health care office in your county. If you don’t know who runs it, call 2-1-1 or search 2-1-1 Texas. In large cities, the hospital district (for example, a county hospital system) often runs its own financial assistance program with higher limits.

Texas Medicaid, CHIP, and Healthy Texas Women

Texas Medicaid and CHIP cover children, pregnant women, parents and caretakers with very low income, seniors, and people with disabilities. Texas has not adopted the Affordable Care Act Medicaid expansion, according to KFF’s state tracker, so most adults without children or a disability do not qualify based on income alone.

Still apply if you might qualify. Medicaid can sometimes cover medical bills from up to three months before the month you apply, if you were eligible then. Under the 2025 federal law, that window shortens to two months for most new applicants starting January 1, 2027, so applying soon matters. Apply at YourTexasBenefits.com, by calling 2-1-1 and choosing option 2, or at a local benefits office.

Healthy Texas Women offers women’s health and family planning services at no cost to eligible women. The Texas HHS policy handbook lists eligibility as women ages 15 to 44 (15 to 17 with a parent applying), with countable income at or below 204.2% of the poverty level, who are not pregnant and do not have other coverage for these services. To apply or find a doctor, call 2-1-1 (option 2) or 1-877-541-7905.

If your income is too high for Medicaid, look at the federal Marketplace at healthcare.gov, where many Texans qualify for premium tax credits.

Cancer screening and treatment help

Texas HHS runs Breast and Cervical Cancer Services, which provides screening and diagnosis for women with low income. Women diagnosed through a program provider may qualify for Medicaid for Breast and Cervical Cancer, which covers treatment. Our guide to financial assistance for cancer patients in Texas lists other treatment, lodging, and travel help.

Disease foundations and patient assistance programs

Once your bills are reduced, the costs that remain are often copays, premiums, and medicines. These groups can help:

• Copay and premium foundations: national charities such as the PAN Foundation and HealthWell Foundation open funds for specific diseases when money is available. Funds open and close during the year, and grant amounts differ by fund.
• Disease groups: many organizations for cancer, kidney disease, MS, and other conditions offer small grants, travel help, or lodging.
• Drug company patient assistance programs: many drug makers give free or low-cost medicine to people with low income and no or limited coverage.
• Search tools: NeedyMeds, a national nonprofit, lists patient assistance programs, disease-based help, and free or low-cost clinics.

Ask the hospital social worker or financial counselor too. They often know which funds are open and can help with the forms.

Comparing Texas medical help options

Medical debt protections in Texas

Texas and federal laws give you some protection while you sort out a bill. The Texas State Law Library medical debt guide summarizes them:

• Itemized bill first: under Texas Health and Safety Code chapter 185, providers must send an itemized bill with plain-language descriptions before sending an account to collections.
• Billing deadline: under Civil Practice and Remedies Code chapter 146, providers must bill you by the first day of the 11th month after care. If they miss it, they cannot collect certain charges.
• Surprise bills: Texas law (SB 1264, effective Sept. 1, 2019) and the federal No Surprises Act protect many insured patients from surprise out-of-network bills, especially in emergencies.
• Credit reports: the three national credit bureaus said in 2023 they would stop reporting medical collections under $500. A 2025 federal rule to remove medical debt from credit reports was struck down by a court, so larger debts can still appear.

If a debt collector is unfair, you can file a complaint with the Texas Attorney General’s consumer protection division. For more ways to handle what you owe, see our guide on help with medical bills in Texas.

Local charities and 2-1-1 Texas

Local charities rarely pay large hospital bills, but they can help with what a medical crisis does to the rest of your budget, like rent, utilities, food, and gas money for treatment trips. Dial 2-1-1 or visit 211texas.org to find churches, Catholic Charities, community action agencies, and free clinics near you. If you lost income because of illness, apply for SNAP to free up money for bills.

What documents do I need to apply?

Expect to show photo ID, Social Security numbers for the people applying, proof of income for the last 30 days, and proof of where you live, plus any paper that shows the emergency itself. Our document checklist explains what counts for each item and what to do if something is missing. If you don't have everything yet, apply anyway and ask the office how long you have to bring the rest.

Steps to take with a large medical bill

1. Don’t pay with a credit card or loan right away; ask for help first.
2. Ask for an itemized bill and check it for errors or duplicate charges.
3. Request the financial assistance application and apply within 240 days of the first bill.
4. Apply for Medicaid, CHIP, or Healthy Texas Women if you might qualify, and ask about past-month coverage.
5. Contact your county about the County Indigent Health Care Program.
6. Ask about a no-interest payment plan for anything left over, and keep copies of everything.

Related guides

• Debt relief for medical bills
• Government assistance for medical debt
• Texas assistance programs
• 211 Texas financial assistance

Frequently asked questions

This guide is general information, not legal advice. Program rules and income limits change, so confirm details with each program. National Relief Program is an independent website and is not affiliated with Texas Health and Human Services, any hospital, or any government agency.