Help paying gas bill for low-income households with health conditions

Introduction

If you are living on a limited income and managing a health condition, a past-due gas bill can feel urgent. Reliable heat supports health and safety, especially for older adults and people with chronic illness. This guide walks through practical, credible options to reduce what you owe, avoid shutoff, and lower bills long term.

This guide explains in clear terms:

• When gas and heat become a health risk (not just a comfort issue)
• The main programs that can help pay a gas bill
• Protections that may apply if you have a medical need
• What to say when you call your gas utility
• What documents to gather so you can apply faster
• What to do if your heat is shut off or your home is getting dangerously cold

Why help with a gas bill can be a health issue

Cold indoor temperatures can be risky for many people, including older adults and those with chronic health problems. As you age, it can be harder to notice when your body is getting too cold, and cold exposure can become dangerous more quickly than you expect.

Hypothermia is a medical emergency that happens when your body temperature drops too low. Some people are at higher risk, including older adults and people with chronic illness.

If you have conditions such as heart disease, lung disease (like COPD or asthma), diabetes, limited mobility, dementia, or you use certain medications that affect alertness, staying safely warm can be part of protecting your health.

Start here if you are behind right now

If your bill is past due or you got a shutoff notice, focus on fast steps first.

• Check the shutoff date and the minimum amount needed to stop disconnection. Many utilities list this on the notice.
• Call your gas utility immediately and ask for “payment options” and “hardship programs.” Tell them you have a health condition in the home if that is true.
• Ask about these options on the same call:
  • A payment plan that spreads what you owe over time
  • Temporary payment extensions
  • Budget billing (sometimes called “level pay”)
  • Any low-income discount rate or arrears support your utility offers
• Apply for energy assistance as soon as possible. Some programs can help prevent shutoff during an energy crisis.

If calling feels overwhelming, it can help to write down a short script before you dial:

• “I’m calling because I’m behind on my gas bill and I’m trying to prevent shutoff.”
• “We have a health condition in the household. Are there medical protections or additional notice requirements in this state?”
• “What programs can reduce my bill or help pay what I owe?”
• “What documents do you need, and where do I send them?”

Programs that can help pay a gas bill

LIHEAP: help paying heating bills and emergency energy support

The Low Income Home Energy Assistance Program (LIHEAP) is a major federal program that helps eligible households with home energy costs. LIHEAP can support heating bills (including natural gas) and may offer emergency assistance during an energy crisis, depending on your state’s program rules and available funding.

Important details to know:

• Eligibility is based on income, and each state runs its own LIHEAP program.
• Some states prioritize people who are older, have disabilities, or have young children, especially for crisis support.
• Applying early can matter because LIHEAP funding is limited.

If you are managing a serious health condition, tell your LIHEAP office if:

• A shutoff would put someone at medical risk
• You rely on a safe indoor temperature for health reasons
• You need power or heat to safely recover from illness or prevent complications

Weatherization Assistance Program: lowering future gas bills

If your gas bills are high because your home is hard to heat, weatherization can reduce costs over time. The Weatherization Assistance Program (WAP) helps eligible households improve energy efficiency, which may include steps like sealing air leaks, improving insulation, and addressing heating-related efficiency problems.

Weatherization is not instant bill payment, but it can make future winter bills more manageable and reduce ongoing financial stress.

State, local, and utility discount programs

Many states and utilities offer additional low-income programs beyond LIHEAP. These may include:

• Monthly discount rates
• One-time grants or credits
• Arrearage support programs (help with past-due balances)
• Seasonal protections or special rules during extreme weather

Because these programs vary widely, the most reliable approach is:

• Call your utility and ask what they offer for low-income customers
• Ask your state or local social services office what energy programs they administer
• Ask specifically about “gas assistance,” “energy crisis assistance,” or “winter heating help”

Medical and vulnerable customer protections that may apply

Many states have rules that affect when a utility can disconnect service for non-payment, and some rules consider:

• Current or forecasted weather conditions
• Age (older adults)
• Disability status
• Serious illness or medical need

In some areas, you may be able to file a medical certification (sometimes called a “medical certificate”) showing that a shutoff would be dangerous for someone in the household. Some utilities also offer programs often described as:

• “Medical baseline” (extra energy allowance or reduced rate for medical need)
• “Critical care” or “life support” status (additional notice or priority restoration)

These protections are not the same everywhere, and they may not stop disconnection permanently. They often require paperwork and periodic recertification, so it helps to start early.

Example of what this can look like in practice: California has a Medical Baseline program administered through utilities under state oversight. New York has customer protection rules that address disconnection and consumer safeguards.

Medicare Advantage benefits that may help cover utilities

If you have Medicare Advantage (Part C), your plan may offer supplemental benefits that help with certain everyday needs. Some plans include benefits that can be used for utilities, especially for members with specific chronic conditions or plans designed for higher-need populations.

These benefits are plan-specific. If you think you might have this type of help:

• Look at your plan’s Summary of Benefits or Evidence of Coverage
• Call the number on your member ID card and ask if you have any benefit that can pay a utility bill

Related Understood Care guide: https://understoodcare.com/uc-articles/flex-cards-and-grocery-benefits-that-can-also-pay-rent-or-utilities‍

How to use your health condition to strengthen an application

When a clinician letter can help

Some assistance programs and medical protection forms ask for confirmation from a clinician. If you are requesting a medical certification for shutoff protection, consider asking your clinician to include:

• Your diagnosis or medical condition (as appropriate for the form)
• Why safe indoor heat is medically important for you
• Any risks of cold exposure for your condition
• Whether you use medical equipment or have limitations that increase risk
• The expected duration of the medical need (if known)

If you have trouble getting a clinician letter quickly, ask the utility or agency:

• Whether they accept a nurse practitioner or physician assistant signature
• Whether a hospital discharge summary or recent visit note can be used temporarily
• Whether you can submit partial documentation now and complete the rest later

What documents you may need

Different programs ask for different paperwork, but these are common:

• Photo ID
• Proof of address (lease, mail, or utility bill)
• Most recent gas bill and any shutoff notice
• Proof of income (pay stubs, Social Security award letter, SSI, pension, or benefits letter)
• Household size information
• Proof of participation in certain benefit programs if applicable
• Medical documentation if you are applying for a medical protection or priority status

A helpful Understood Care checklist you can use to organize paperwork:
https://understoodcare.com/uc-articles/checklist-documents-to-gather-before-applying-for-food-or-housing-help

If your heat is off or your home is getting dangerously cold

If you feel confused, excessively sleepy, or unable to warm up, treat this as urgent. Hypothermia is a medical emergency.

If you are trying to stay warm during a shutoff or outage:

• Go somewhere warm if you can. This may include a trusted friend’s home, a warming center, a library, or another public building.
• Layer clothing and use blankets. Cover your head and feet since heat loss can be significant.
• Avoid unsafe indoor heating. Using ovens, grills, or unvented fuel-burning devices indoors can increase fire risk and carbon monoxide poisoning risk.
• Use generators safely. Generators should be used outdoors and far from windows, doors, and vents.

If you smell gas at any time, leave the area and contact your utility or emergency services immediately.

How Understood Care can support you

If you are juggling medical needs and a financial crisis, you do not have to navigate every program alone. Understood Care can help you get organized, understand options, and prepare to apply for assistance programs.

You can also explore broader resources here:
https://understoodcare.com/uc-articles/financial-help‍

FAQ

• How can I get help paying my gas bill if I have a disability or chronic illness?
  Start by asking your utility about hardship programs and medical protections, then apply for LIHEAP and ask about crisis assistance if you have a shutoff notice.
• Does LIHEAP help pay natural gas bills?
  LIHEAP can help with home energy costs, including heating, and many households use it for gas heating.
• Can I stop a gas shutoff if someone in my home has a medical condition?
  Some states and utilities have medical certification options or added protections, but rules vary. Call the utility right away and ask what documentation they require.
• What is a medical baseline program for utilities?
  In some areas, a medical baseline or similar program can reduce bills or provide additional protections when someone has a verified medical need.
• Can Medicare Advantage help pay utility bills like gas?
  Some Medicare Advantage plans offer supplemental benefits that may help with utilities, especially for members with certain chronic conditions. Benefits depend on the plan.
• What documents do I need to apply for gas bill assistance?
  Often you need ID, proof of address, proof of income, and your current gas bill or shutoff notice. Medical documentation may help for certain protections.
• What should I do if my home is too cold and I feel sick?
  Seek urgent help. Hypothermia is a medical emergency, and symptoms like confusion or extreme sleepiness can be dangerous.

References

• USAGov: Get help with energy bills (LIHEAP and WAP)
  https://www.usa.gov/help-with-energy-bills USAGov
• U.S. Department of Energy: Weatherization Assistance Program
  https://www.energy.gov/scep/wap/weatherization-assistance-program The Department of Energy's Energy.gov
• USAGov: Home weatherization and energy efficiency assistance
  https://www.usa.gov/weatherization-energy-programs USAGov
• CDC: Preventing hypothermia
  https://www.cdc.gov/winter-weather/prevention/index.html CDC
• National Institute on Aging: Cold weather safety for older adults
  https://www.nia.nih.gov/health/safety/cold-weather-safety-older-adults National Institute on Aging
• Mayo Clinic: Hypothermia symptoms and causes
  https://www.mayoclinic.org/diseases-conditions/hypothermia/symptoms-causes/syc-20352682 Mayo Clinic
• MedlinePlus (NIH): Hypothermia
  https://medlineplus.gov/hypothermia.html MedlinePlus
• JAMA Patient Page: Hypothermia
  https://jamanetwork.com/journals/jama/fullarticle/2676112 JAMA Network
• CDC: Generator safety and carbon monoxide prevention
  https://www.cdc.gov/carbon-monoxide/factsheets/generator-safety-fact-sheet.html CDC
• U.S. Consumer Product Safety Commission: Winter storm safety tips (CO and fire prevention)
  https://www.cpsc.gov/Newsroom/News-Releases/2026/As-Winter-Storms-Threaten-Millions-in-the-US-CPSC-Issues-Safety-Tips-to-Help-Families-Prevent-Carbon-Monoxide-Poisoning-and-Fires U.S. Consumer Product Safety Commission
• California Public Utilities Commission: Medical Baseline program (example of medical utility support)
  https://www.cpuc.ca.gov/consumer-support/financial-assistance-savings-and-discounts/medical-baseline California Public Utilities Commission
• New York Department of Public Service: Utility customer protections (example of state protections)
  https://dps.ny.gov/news/psc-actions-protect-utility-customers Department of Public Service
• CMS: Special Supplemental Benefits for the Chronically Ill (Medicare Advantage)
  https://www.cms.gov/medicare/health-plans/healthplansgeninfo/downloads/supplemental_benefits_chronically_ill_hpms_042419.pdf Centers for Medicare & Medicaid Services
• Frontiers in Cardiovascular Medicine: Systematic review and meta-analysis on cold exposure and cardiovascular outcomes
  https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1084611/full frontiersin.org‍