Patient Rights

Washington Patient Billing Rights

Know your rights as a patient in Washington. From surprise billing protections to financial assistance programs, here's what the law says about your medical bills.

Surprise Billing Financial Assistance Additional Rights File a Complaint

Protection

Surprise Billing Protections

Balance Billing Protection Act (BBPA) — Washington's BBPA (2019) is one of the strongest state surprise billing laws in the country, protecting patients from unexpected out-of-network bills for emergency and non-emergency services at in-network facilities.

Patients are protected from surprise bills for emergency services at any hospital.
Out-of-network providers at in-network facilities cannot balance bill patients — they can only charge in-network cost-sharing amounts.
Applies to services at hospitals, ambulatory surgical facilities, and freestanding emergency departments.
Disputes between providers and insurers go through an independent arbitration process.
Air ambulance services are included under state protections.

What this means for you

If you receive a surprise out-of-network bill, you are not responsible for the balance beyond what you'd pay for in-network care. Contact your insurer and reference the Balance Billing Protection Act (BBPA) to dispute any balance bill.

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Assistance

Financial Assistance & Charity Care

Under Charity Care Law (RCW 70.170), hospitals in Washington must provide financial assistance to qualifying patients.

All hospitals must provide charity care (free or reduced-cost care) to patients who qualify based on income.
Patients at or below 300% of the Federal Poverty Level (FPL) qualify for charity care — about $93,600 for a family of four in 2026.
Hospitals must screen patients for charity care eligibility before sending bills to collections.
Hospitals must post their charity care policies in prominent locations and in multiple languages.
Patients can apply for charity care up to the time the debt is sent to collections.

How to apply

Ask the hospital's billing department for a financial assistance application.
Gather proof of income (pay stubs, tax return, benefit letters).
Submit the application — you can often do this even after receiving a bill.
If denied, appeal the decision and contact your state insurance department.

Know Your Rights

Additional Patient Rights in Washington

Beyond surprise billing and financial assistance, Washington law provides these important protections.

Good Faith Estimates

Uninsured or self-pay patients can request a good faith estimate of charges before receiving care. Hospitals must provide this within 3 business days.

Itemized Bills

You have the right to an itemized bill showing each charge. Hospitals must provide this within 30 days of request.

Payment Plans

Hospitals must offer reasonable payment plans before pursuing collections. Minimum monthly payment cannot exceed 10% of monthly income for low-income patients.

Collection Protections

Hospitals cannot report medical debt to credit agencies for 120 days after the first bill. They must also provide written notice of financial assistance programs before initiating collection actions.

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