50-state desk · IN
Indiana
Process / partialHospitals must maintain a financial-assistance policy and community-benefit reporting. There is no statewide FPL write-off floor. Medicaid is expanded (HIP).
Ind. Code ch. 16-21-9 (community benefits / financial assistance policy) · 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 | 6 years · Ind. Code § 34-11-2-9 |
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 | $15,960 | — | — |
| 2 | $21,640 | — | — |
| 3 | $27,320 | — | — |
| 4 | $33,000 | — | — |
| 5 | $38,680 | — | — |
| 6 | $44,360 | — | — |
What to do
- 01 Indiana requires a policy, not a 200% write-off. Download the hospital’s FAP PDF and apply to its line.
- 02 HIP / Medicaid expansion is available near 138% FPL — apply retroactively if the date of service is recent.
- 03 Itemize and ask for the self-pay schedule.
- 04 Six-year lawsuit window.
Appeals
Federal No Surprises Act.
Insurance: Indiana Department of Insurance — external review
Medicaid: FSSA / HIP fair hearing.
Medicare is federal regardless of state: redetermination, reconsideration, ALJ, Appeals Council, then district court.
Cite this in a letter
I request a determination under your financial-assistance policy required by Indiana Code chapter 16-21-9 and under Internal Revenue Code section 501(r) if you are a 501(c)(3) hospital.
Put a Indiana bill in the machine.
The estimate will use this state’s floors. The letters will cite Ind. Code ch. 16-21-9 (community benefits / financial assistance policy).
Start a Indiana 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.
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.