Alaska

Federal FAP only

No statewide income floor. Alaska uses higher HHS poverty guidelines. Medicaid is expanded to 138% of the Alaska FPL.

I.R.C. § 501(r) (nonprofit hospitals) · compiled September 2026

Rule	This state
Free-care floor	—
Discount / eligibility floor	—
Covers insured patients	Yes, if they otherwise qualify
Which hospitals	Nonprofit / 501(c)(3) hospitals via federal 501(r)
Medicaid expansion	Yes — adults to 138% FPL
Screen before collections	Not required by state law
Credit reports	No state ban
Debt sales	Not banned
Home liens	Not banned
Wage garnishment	Federal CCPA cap (typically 25%)
Interest on medical debt	No special cap located
Collection hold	No extra state waiting period
Lawsuit clock	3 years · Alaska Stat. § 09.10.053

2026 poverty line here

Alaska and Hawaii use their own HHS tables. Everyone else uses the 48-state and D.C. figures, effective January 2026.

Household	100%	Free floor	Discount floor
1	$19,950	—	—
2	$27,050	—	—
3	$34,150	—	—
4	$41,250	—	—
5	$48,350	—	—
6	$55,450	—	—

What to do

01 Use Alaska FPL figures (they are higher than the 48-state table) on the FAP application.
02 If this was air ambulance, invoke the No Surprises Act and refuse balance billing beyond in-network cost-share.
03 Send the itemized bill request before paying a bush-hospital chargemaster rate.
04 FDCPA validation if a collector is involved. Alaska’s written-contract lawsuit window is three years.

Appeals

Federal No Surprises Act. Air-ambulance balance billing is a recurring Alaska issue — NSA covers air ambulance.

Insurance: Alaska Division of Insurance — external review

Medicaid: Alaska Department of Health fair hearing.

Medicare is federal regardless of state: redetermination, reconsideration, ALJ, Appeals Council, then district court.

Cite this in a letter

I request a FAP determination under Internal Revenue Code section 501(r). Alaska’s 2026 HHS poverty guideline, not the 48-state table, is the correct household line.

Put a Alaska bill in the machine.

The estimate will use this state’s floors. The letters will cite I.R.C. § 501(r) (nonprofit hospitals).

Start a Alaska case

Alaska Attorney General

Federal overlay — every state

501(r)
501(c)(3) hospital organizations must publish a Financial Assistance Policy, a plain-language summary, and generally may not take extraordinary collection actions (selling the debt, reporting it, liens, lawsuits) until they have made reasonable efforts to determine FAP eligibility.
No Surprises Act
Emergency services, air ambulance, and many out-of-network clinicians at in-network facilities cannot balance-bill beyond in-network cost-sharing. Independent dispute resolution is between the plan and the provider — not a reason to pay the sticker rate.
FDCPA
15 U.S.C. § 1692g. Within 30 days of first collector contact, demand validation. Until validated, collection and credit reporting should stop. Partial payment can restart a state’s statute of limitations.
EMTALA
Emergency departments must screen and stabilize regardless of ability to pay. An ER bill is not an agreement that chargemaster rates are the cash price.
Medicare appeals
Five levels: redetermination (MAC, 120 days), reconsideration (QIC), ALJ at OMHA, Medicare Appeals Council, then federal district court. A remaining patient balance is often a claim the provider still needs to work.
Credit bureaus
The CFPB’s 2025 medical-debt reporting rule was vacated in July 2025. Industry practice still generally omits paid medical collections and unpaid balances under $500. Unpaid medical debt over $500 can appear after a delay unless a state ban applies. FCRA-preemption fights over those state bans are ongoing.