New Patient Financial Assistance Law Goes into Effect for Hospitals

Patient financial help in hospitals. Vermont map. Sign with a capital H.

As of July 1, 2024, Vermont has new rules for hospital Patient Financial Assistance (PFA). Many Vermont residents will now qualify for help. Read below to learn more about PFA, what’s changing, and how this could help you!

What is patient financial assistance (PFA)?

PFA can help you pay for the care you need. It covers most medically necessary care. It can help if you are uninsured or if you have insurance but need help paying your out-of-pocket costs. To learn more about PFA at your local hospital and other financial assistance programs in your area, visit our web page called Patient Financial Assistance & Affordable Medical Care in Vermont.

What is changing under the new law?

In the past, hospitals used different rules to decide who would qualify for financial assistance. Under the new law, all hospitals in Vermont must meet minimum standards for providing financial assistance. For example, hospitals must:

  • Use the same income and household size rules when checking to see if a patient is eligible for assistance.
  • Use the same definition of who qualifies as a “Vermont resident:”
    • You must live in Vermont or plan to live in Vermont. This includes students, non-citizens, and those who are unhoused. People who are employed in Vermont but live in another state also qualify.
  • Give minimum discounts to those who qualify:
    • 100% discount if household income is less than 250% FPL
    • Minimum of 40% discount if household income is less than 400% FPL
    • See details on how to estimate your Modified Adjusted Gross Income so you can compare it to the Federal Poverty Level (FPL) guidelines. For many people, Modified Adjusted Gross Income is the same as the Adjusted Gross Income on your tax return.

What does the new law mean for Vermonters?

These changes will level the playing field. No matter where you live in Vermont, you can apply under the same basic rules for financial assistance at any hospital in the state. It also guarantees minimum discount amounts to help people who are struggling to pay out-of-pocket costs.

Learn more:

Updated: Jul 03, 2024