The MHS Modified Payment and Waiver Program helps civilian, non-DOD beneficiary patients who received medical services at military hospitals or clinics and can’t pay their medical bills. Under the modified waiver and payment program, qualified individuals may have their medical bills discounted or waived.

Any civilian who:

• Isn’t entitled to medical benefits as a DOD beneficiary, and
• Received care at a military hospital or clinic on or after June 21, 2023.

If eligible, you may apply to the program. You must submit a completed DD Form 3201 within 90 days of the date of your medical invoice.

All care received on or after June 21, 2023, is eligible for discount under the waiver and payment program.

To apply for the program:

• Download, complete, and sign DD Form 3201A,”Request for Medical Debt Waiver Under the Military Health System Modified Payment and Waiver Program”.
• Submit, along with the form:
  • Your prior year tax return,
  • Your two most recent pay stubs, and/or
  • Other relevant income documentation.
• Send your application and your supporting documentation to the address listed on your medical invoice.

Forms and information are available at [insert link].

In Section 716 of the James M. Inhofe National Defense Authorization Act for Fiscal Year 2023, Congress authorized financial relief to eligible civilian non-beneficiary patients.

The MHS Modified Payment and Waiver Program doesn’t apply for dates of service before June 21, 2023.

For more information on the MHS Modified Payment and Waiver Program, call the phone number on your medical invoice.

The maximum payment term is 72 months. If your term is less than 72 months, call the phone number on your medical invoice. You can request a payment term extension.

Once your delinquent account is transferred to collections, you can’t apply to the MHS Modified Payment and Waiver Program. You must work with the Department of the Treasury directly.

Your application must be received no later than 90 days from the date on your medical invoice. If your application isn’t received by that date, and no payment is received for your medical invoice, then your account will be transferred to the Department of the Treasury for collections.

You can request a temporary three-month debt collection suspension once per 12-month period of your voluntary repayment agreement. If your circumstances are unique and you require additional suspension terms, then you should call the phone number on your medical invoice.

Call the phone number on your medical invoice.

If your request to temporarily suspend your debt collection is denied, then you’re expected to resume payments that are in your voluntary repayment agreement. This will prevent your account from being sent to collections.

If your request to temporarily suspend your debt collection is approved, your account will be temporarily suspended. Your account will be suspended for the length you requested on the DD Form 3201-2, Request for Temporary Medical Debt Suspension. You’ll be given a suspension termination date. After that date, you’ll be expected to resume payments that are in your voluntary repayment agreement.

To apply for a full waiver of the adjusted balance:

• Download, complete, and sign DD Form 3201-1, Request for Medical Debt Waiver.
• Mail the DD Form 3201-1 to the address on your medical invoice.

You’ll get, by mail, a debt waiver decision notification. You’ll get your notification no more than 30 days from the date your request is received.

If your request for a waiver is denied, then you’ll be expected to resume payments that are in your voluntary repayment agreement.

If your request for a debt waiver is approved, then your account will be closed. You’ll get an IRS Form 1099C. You must file the form with your next federal tax return.

Call the phone number on your medical invoice.