When you're uninsured or underinsured and need a procedure, two paths emerge that most people don't know about: hospital charity care programs and medical tourism. They solve the same problem — affordability — through completely different mechanisms.
Charity care: what it is and who qualifies
Nonprofit hospitals are required to provide charity care (also called financial assistance) as a condition of their tax-exempt status. This can range from a percentage discount to 100% free care. Eligibility is typically based on income relative to the Federal Poverty Level (FPL).
General thresholds (vary by hospital): Below 200% FPL ($31,200 individual, $64,400 family of 4 in 2026): often 100% free care. Between 200–400% FPL: sliding-scale discount (50–80% off). Above 400% FPL: may still qualify for modest discounts at some hospitals.
The catch: Charity care is generally available only for medically necessary procedures at nonprofit hospitals. Cosmetic procedures, dental implants, fertility treatments, and other commonly denied categories are typically excluded from charity care programs too. You're trading one "not covered" for another.
Medical tourism: what it covers
Medical tourism has no eligibility requirements, income thresholds, or procedure exclusions. If a provider offers the procedure and you can pay the (much lower) international price, you qualify. It covers everything charity care doesn't — cosmetic surgery, dental implants, fertility treatments, vision correction, and elective orthopedics.
Head-to-head comparison
| Factor | Charity care | Medical tourism |
|---|---|---|
| Eligibility | Income-based (often below 400% FPL) | None — anyone can access |
| Procedure coverage | Medically necessary only | All procedures |
| Cost to patient | Free to heavily discounted | 50–80% below US prices |
| Wait time | Often weeks to months | Usually 4–8 weeks from decision |
| Application process | Income documentation required | Virtual consultation + booking |
| Provider choice | Limited to participating hospital | You choose provider and location |
| Follow-up care | Same facility | Telehealth + local provider |
When to pursue each
Pursue charity care when: Your income is below 300% FPL, the procedure is medically necessary (not excluded from charity programs), you're near a nonprofit hospital, and you can wait for processing and scheduling.
Pursue medical tourism when: You don't qualify for charity care (income too high), the procedure is excluded from charity programs (cosmetic, dental, fertility), you want to choose your provider and timing, or the charity care wait time is unacceptable.
Pursue both simultaneously: Apply for charity care while researching medical tourism. If charity care comes through, great. If not, you haven't lost any planning time.
Ready to explore your options?
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Explore medical care in Colombia →Frequently asked questions
What is hospital charity care?
Charity care is financial assistance provided by nonprofit hospitals to patients who can't afford their bills. It can range from partial discounts to 100% free care, based on income relative to the Federal Poverty Level. All nonprofit hospitals are required to have charity care programs.
How do I apply for charity care?
Contact the hospital's financial assistance or billing department. You'll need to provide proof of income (pay stubs, tax returns), household size documentation, and a financial assistance application. Apply before the procedure if possible — it's easier to get approved in advance than to negotiate after the fact.
Does charity care cover dental implants or cosmetic surgery?
Generally no. Most charity care programs cover only medically necessary procedures. Dental implants, cosmetic surgery, fertility treatments, and elective procedures are typically excluded — the same categories insurance often denies.
Can I apply for charity care and plan medical tourism at the same time?
Absolutely. Apply for charity care while simultaneously researching international options. If charity care comes through, you can cancel your international plans. If it doesn't, you'll already have your Plan B ready.