50-state desk · AK
Alaska
Federal FAP onlyNo 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 October 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 caseFederal 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.
Official sourceNo 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.
Official sourceFDCPA
15 U.S.C. § 1692g. Within 30 days of first collector contact, demand validation. Until it is validated, the collector should stop collecting. Partial payment can restart a state’s statute of limitations.
Official sourceEMTALA
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.
Official sourceMedicare 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.
Official sourceCredit 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.
Official source
Sources
Official government sources for the Alaska information on this page. UNDUE does not represent any government entity.
- Alaska Stat. § 09.10.053 (lawsuit clock, 3 years)
- Alaska Division of Insurance, external review guide (PDF)
- Alaska Medicaid recipient handbook (Fair Hearings section, Dept. of Health PDF)
- Alaska Medicaid member resources portal (fair hearings resources)
- Alaska Attorney General
- 2026 federal poverty guidelines (U.S. Dept. of Health and Human Services, published on HealthCare.gov)
- Medicaid and CHIP by state (HealthCare.gov)
- 15 U.S.C. § 1673 federal wage-garnishment cap (GovInfo)