Written by a parent, not a doctor. Nothing here is medical advice.

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Help reducing hospital bills (financial assistance)

Your hospital’s financial-assistance policy may reduce treatment bills, including some costs left after insurance.

What it is

Your hospital’s financial-assistance policy may reduce treatment bills, including some costs left after insurance.

A work plan can still leave a large hospital bill. The financial counselor can check the hospital’s assistance policy alongside your insurance. The uninsured price cap and each hospital’s assistance policy are separate protections.

Hospital policies
  • St. Jude says accepted patients receive automatic assistance and no bill from St. Jude for treatment, travel, housing or food. Care at an affiliate needs St. Jude’s advance approval under its published policy. An independent doctor’s bill or travel arrangement needs its own written check.
  • The linked Dolly Parton Children’s policy is dated November 5, 2020; its current application to your bill needs confirmation. That historical document describes full assistance strictly below 250% of poverty and partial assistance through 400%, with additional rules for insured patients. The financial counselor should supply the current policy and identify the services and clinicians it covers.
  • Erlanger’s policy effective April 1, 2026 can provide full assistance for covered medically necessary or emergency care at income at or below 300% of the federal poverty guideline when its available-assets test is also met; an above-limit hardship decision is discretionary. Insured patients can be considered after other payment sources, but service, location and clinician exclusions matter, including the policy’s general transplant exclusion and separate conditions for some nonemergency services. Vanderbilt’s currently linked policy is effective July 1, 2026, and its counselor should confirm the applicable income and high-expense schedules for the particular bill. Its posted 24% amounts-generally-billed figure is not an income threshold. The financial counselor must confirm the policy, dates, covered clinicians and particular treatment before anyone estimates the remaining bill.
What you get
  • A reduction or write-off of eligible hospital bills.
  • A written decision showing which accounts and dates the assistance covers.
Federal protections when section 501(r) applies
  • At a covered tax-exempt hospital, the application period runs at least 240 days after the first post-discharge bill. Extraordinary collection actions cannot begin during the first 120 days. Additional notice and assistance-review duties apply.
  • A timely complete application suspends extraordinary collection actions during review. An approved application can require a refund of payments above the assistance amount when the excess is $5 or more.
  • Federal section 501(r) applies to qualifying tax-exempt hospital organizations on a facility-by-facility basis, not merely because a hospital is described as nonprofit or public. St. Jude identifies itself as a 501(c)(3) organization and says accepted patients automatically receive its assistance without a bill from St. Jude. For Vanderbilt, Erlanger and Dolly Parton Children’s bills, the counselor should identify the legal billing entity, the applicable federal protections and which separate clinician bills the policy covers. The 120-day extraordinary-collection protection and at least 240-day assistance-application period do not mean all ordinary collection activity automatically stops.
If you decide to apply
  1. Ask the hospital financial counselor for its policy, application and list of doctors whose bills it covers.
  2. Have ready: current income records, insurance statements and the bills or account numbers.
  3. Ask which collection activity pauses during the review, and keep the answer in writing.

Your hospital’s financial counselor

People who can help
  • St. Jude: 901-595-3345. Vanderbilt financial counseling: 615-936-0910. Dolly Parton Children’s patient accounts: 865-541-8187. Erlanger billing: 423-778-5150.
Good to know

An outside doctor can bill separately and may not be covered by the hospital’s policy. Paying a bill does not always end your right to assistance.

Uninsured bills
  • Tennessee’s separate uninsured-patient price ceiling is 175% of the facility’s cost. It is not a statewide free-care income threshold.
Official sources
Ask your social worker

“Could the hospital reduce our bills after insurance, which accounts would qualify, and could you help us with the application?”

Why I’m asking: I want to understand the assistance before we agree to payments we may not owe.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Ask for the application, send proof of income, and do not pay or put a bill on a card while it is open.

Your social worker

The social worker connects you with the financial counselor. The counselor checks Medicaid and explains which providers the assistance covers.

The care team

Records and letters when the application asks for them.

Who decides
The hospital's financial-assistance office under its written policy
Ask the billing office
“I would like to apply under the hospital's financial assistance policy. What is the income ceiling, which providers are covered by it, and can you hold collections while it is reviewed?”

How to apply

First step: Call the hospital's financial counselor, say “financial assistance policy”, and ask for the application, the income table and the list of covered providers.

  1. Call the financial counselor and say “financial assistance policy”.
  2. Ask which providers are covered by it.
  3. Ask for a collection hold while it is reviewed.

Where it starts: Apply to the hospital; the financial counselor checks Medicaid at the same time

What to gather

  • Proof of household income (pay stubs or last tax return)
  • The insurance card and recent explanation-of-benefits statements
  • The bills or account numbers

How long: A decision within weeks of a complete application. A nonprofit hospital may not sue, report the debt or garnish wages for at least 120 days after the first bill after discharge, and holds collections while it decides.

What a yes looks like

A letter naming the discount percent and the period it covers (often 12 months). If you paid before the decision, a refund of the difference follows. Re-apply when it lapses.

What a no looks like, and the next move

“Over the income limit”: ask about the high-medical-expense branch, a prompt-pay discount and an interest-free plan. Then go to bill negotiation.

Watch out

  • Apply before paying if you can. If you already paid, apply anyway: within 240 days of the first bill after discharge, an approved application means the hospital refunds what you paid above the assistance amount ($5 or more).
  • Doctors who bill separately (anesthesia, radiology, some oncologists) may not be under the hospital's policy. Ask which providers are covered.
  • Insured families count too: some hospitals have a high-medical-expense branch that discounts at any income when bills pass a share of income.

Each hospital’s own policy

The federal rule sets the floor; each hospital’s policy sets the actual numbers. “Unknown” means the policy could not be read yet: call the number and ask.

HospitalFree care up toDiscounts up toInsured familiesFinancial counselor
St. Jude Children's Research Hospital · policyunknownunknownyes901-595-3345
Monroe Carell Jr. Children's Hospital at Vanderbilt · policyunknownunknownyes615-936-0910
Dolly Parton Children's Hospital · policy250% FPL400% FPLyes865-541-8187
Children's Hospital at Erlanger · policy300% FPLunknownyes423-778-5150

The numbers and the rules

The arcane layer, kept on purpose. Checked September 8, 2026.

What it is worth

The hospital's own bill reduced or written off entirely under its published schedule. Collections held while the application is open.

  • Discount or charity write-off — Discount or charity write-off
  • $240 (at least; a policy can allow longer) — Days to apply after the first bill after discharge
  • $120 (at least) — Days after that first bill before the hospital can sue, report the debt or garnish wages
  • $5 (refunded when $5 or more) — Refund of what you paid above the assistance amount

Legal protection: A written policy and application, published · Limits on collection actions while the application is reviewed · At a nonprofit hospital, an application filed within 240 days of the first bill after discharge must be taken (federal rule) · No lawsuit, credit reporting, wage garnishment or sale of the debt for at least 120 days after that first bill · If you already paid and the application is approved, the hospital refunds what you paid above the assistance amount ($5 or more)

What it costs the family: Free application.

The eligibility facts, as published

Tax exempt hospital for federal floor
yes
Policy specific
yes
Insured patients
often eligible; some policies add a high-medical-expense branch at any income; a children's hospital policy often reaches families at 400% of the poverty line and above
Federal 501r floor
nonprofit (tax-exempt) hospitals: application period runs to at least the 240th day after the first post-discharge bill; no extraordinary collection actions for at least 120 days after that bill; refund of amounts paid above the assistance amount when $5 or more

Decisions this site cannot make: Hospital policy eligibility

Expect friction on: Separately billing physicians · Documentation · Application deadlines

The trap: Paying first and then not applying. If you already paid and the application is approved in time, the hospital must refund what you paid above the assistance amount ($5 or more). Doctors who bill separately may not be under the hospital's policy.

What changes by state: Some states set minimum hospital discounts, including California. Your hospital sets its own assistance limits and provides a financial counselor.

Where I read this

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