How Medical Baseline Utility Programs Work

What a medical baseline program does

A medical baseline program sets a lower minimum electricity or gas bill for households where someone has a medical condition that requires constant use of electric or gas equipment. Instead of paying based on what you actually use, you pay a reduced rate on a baseline amount — the amount the utility company decides is medically necessary — and then a higher rate on anything you use above that.

The program does not reduce your total bill automatically. It reduces the rate you pay on a portion of your usage. If you use significantly more power than the baseline because of your medical equipment, you will still pay more than someone without medical needs, but you will pay less than you would without the program.

Medical baseline programs exist in most states, but they are run by individual utility companies, not by a single federal program. The rules, the baseline amount, and the discount vary depending on which utility serves your area.

Key Takeaways

• Medical baseline programs reduce the rate you pay on a set amount of electricity or gas use, not the total bill itself.
• You must have a medical condition that requires continuous use of electric or gas equipment, and a doctor or nurse practitioner must verify it in writing.
• The baseline amount and discount percentage differ by utility company and state, so contact your provider directly to learn what you would receive.
• Once you are enrolled, the reduced rate applies automatically each month as long as you remain on the program.
• You may be able to combine medical baseline with other bill assistance programs, such as LIHEAP, to lower your costs further.

Which medical conditions may have access to

Medical baseline programs do not have a fixed list of conditions. Instead, they require that a licensed medical professional — usually a doctor, nurse practitioner, or physician assistant — certify that you have a condition requiring continuous use of specific equipment. The equipment itself is what matters, not the diagnosis.

Common equipment that qualifies includes oxygen concentrators, ventilators, dialysis machines, electric wheelchairs, CPAP machines, and refrigeration units for insulin or other temperature-sensitive medications. Some programs also cover air conditioning or heating when medically necessary, though the rules for climate control are stricter and vary widely.

Your doctor does not need to fill out a special form in most cases. They can write a letter on their letterhead stating that you require continuous use of the equipment and why. Some utilities provide their own certification form, which you can ask your doctor to complete instead.

How to enroll in your utility company's program

Contact your electricity or gas provider directly — the company whose name appears on your bill. Ask specifically for the medical baseline program, sometimes called the medical necessity program or lifeline rate program. The utility will send you an application and a medical certification form.

You will need to provide your account number, proof of residency (usually a recent bill), and the medical certification signed by your doctor. Some utilities accept the certification by mail; others require it to be submitted by the medical provider directly. Ask which method your utility prefers before you have your doctor sign anything.

Processing time varies. Some utilities enroll you within two weeks; others take four to six weeks. Once you are approved, the reduced rate takes effect on your next billing cycle and continues automatically each month.

If your utility denies your request, ask for the reason in writing. Some utilities have an appeal process, and some states have utility commissions that can review denials.

What the baseline amount covers

The baseline is the amount of electricity or gas the utility company decides is medically necessary for your household. It is not based on what you actually use — it is a fixed number set by the utility or by state regulation.

Baseline amounts vary significantly. Some utilities set a baseline of 300 kilowatt-hours per month for electricity; others use 400 or 500. Gas baselines might be 30 or 40 therms per month. The baseline is the same for all medical baseline customers in that utility's service area, regardless of which equipment you use.

You pay a lower rate on usage up to the baseline. Anything you use above the baseline is charged at the regular or higher rate. If your medical equipment uses more power than the baseline allows, you will still see higher bills than customers without medical needs, but the baseline protects you from paying the highest rate on all your usage.

Combining medical baseline with other assistance

Medical baseline and LIHEAP are separate programs that can work together. LIHEAP pays a portion of your bill directly to the utility; medical baseline reduces the rate you pay on part of your usage. You can be enrolled in both at the same time.

Some states also offer additional programs for people with disabilities or chronic illnesses — utility company hardship programs, state-funded bill assistance, or weatherization services that reduce energy use. Your local Area Agency on Aging or disability services office can tell you which programs operate in your area.

When you contact your utility about medical baseline, ask whether they also have a hardship program or low-income rate option. Some utilities stack these benefits; others do not. Knowing what is available before you apply helps you plan which programs to pursue first.

What happens if your medical needs change

If you no longer need the medical equipment, contact your utility and ask to be removed from the program. You will return to the standard rate structure.

If your medical needs increase — for example, if you add a second oxygen concentrator or begin using a ventilator in addition to existing equipment — contact your utility and ask whether your baseline should be adjusted. Some utilities will increase the baseline with updated medical certification; others will not. Ask before you assume the program will expand to cover additional equipment.

Medical baseline enrollment does not expire automatically. You remain on the program until you request removal or until the utility contacts you for recertification. Some utilities recertify every two or three years; others do not recertify at all. When your utility contacts you, respond promptly with updated medical certification to avoid losing the program.

Frequently Asked Questions

Does medical baseline reduce my bill, or just the rate I pay?

It reduces the rate you pay on a portion of your usage, not your total bill. You pay a lower rate on the baseline amount and a higher rate on anything above it. If you use significantly more power because of medical equipment, your bill will still be higher than someone without medical needs.

What if my doctor will not sign the medical certification?

Ask your doctor why. Some doctors are unfamiliar with the program and worry about liability. Bring them a copy of your utility's medical certification form and explain that you need them to verify only that you require continuous use of specific equipment. If your primary doctor refuses, ask a nurse practitioner, physician assistant, or specialist who treats your condition.

Can I get medical baseline if I rent instead of own my home?

Yes. Medical baseline is tied to the utility account, not to property ownership. If the account is in your name, you can enroll. If your landlord pays the utility bill directly, ask whether you can transfer the account to your name or whether the landlord will allow you to enroll on their behalf. Some utilities allow both; others do not.

How much money will I save?

The savings depend on how much you use above the baseline and what your utility's rates are. Contact your utility directly and ask them to estimate your savings based on your typical usage. They can show you what you would pay with and without the program.

What if my utility company says I do not may have access to?

Ask for the reason in writing. Common reasons for denial include incomplete medical certification, equipment that the utility does not recognize as medically necessary, or an account that is not in your name. If you believe the denial is wrong, ask about the appeal process or contact your state's public utilities commission.