50-state desk · OH
Ohio
Process / partialHCAP requires participating hospitals to provide basic, medically necessary services without charge to uninsured Ohio residents at or below 100% FPL. That is a low floor. Above it, use the hospital FAP and 501(r). Medicaid is expanded.
Ohio Rev. Code § 5168.14 (Hospital Care Assurance Program) · compiled October 2026
| Rule | This state |
|---|---|
| Free-care floor | 100% FPL |
| Discount / eligibility floor | 100% FPL |
| Covers insured patients | Uninsured-focused statute |
| Which hospitals | Generally all licensed hospitals |
| Medicaid expansion | Yes — adults to 138% FPL |
| Screen before collections | Yes |
| 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 · Ohio Rev. Code § 2305.06 |
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 | $15,960 | $15,960 |
| 2 | $21,640 | $21,640 | $21,640 |
| 3 | $27,320 | $27,320 | $27,320 |
| 4 | $33,000 | $33,000 | $33,000 |
| 5 | $38,680 | $38,680 | $38,680 |
| 6 | $44,360 | $44,360 | $44,360 |
What to do
- 01 Uninsured at or under poverty: demand HCAP, not a payment plan.
- 02 Above 100% FPL, HCAP ends. The hospital FAP (often 200–400%) is the real write-off.
- 03 Apply for Medicaid — Ohio expanded.
- 04 Six-year lawsuit window.
Appeals
Federal No Surprises Act.
Insurance: Ohio Department of Insurance — external review
Medicaid: ODM fair hearing.
Medicare is federal regardless of state: redetermination, reconsideration, ALJ, Appeals Council, then district court.
Cite this in a letter
If I am an uninsured Ohio resident at or below 100% of FPL, I request Hospital Care Assurance Program coverage under Ohio Rev. Code § 5168.14. I also request a full FAP review under Internal Revenue Code section 501(r).
Put a Ohio bill in the machine.
The estimate will use this state’s floors. The letters will cite Ohio Rev. Code § 5168.14 (Hospital Care Assurance Program).
Start a Ohio 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 Ohio information on this page. UNDUE does not represent any government entity.
- Ohio Rev. Code § 5168.14 (Hospital Care Assurance Program: free basic hospital services at or below 100% FPL)
- Ohio Rev. Code § 2305.06 (lawsuit clock, 6 years on written contracts)
- Ohio Department of Insurance, Health Coverage and External Review Appeals Process
- ODJFS, Explanation of State Hearing Procedures (Ohio Medicaid state hearings, JFS 04059)
- Ohio Administrative Code 5101:6-5-01 (state hearing requests)
- Ohio 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)