Ballad Health Financial Assistance: Free Care Under 225% FPL + 85% Self-Pay Discount (2026 Guide)
Ballad Health offers 100% free care for patients with household income at or below 225% FPL, with sliding-scale discounts up to 450% FPL. All self-pay patients automatically receive an 85% discount off charges. This guide covers all 21 hospitals across Northeast Tennessee and Southwest Virginia.
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Quick Facts
100% Free Care
Household income at or below 225% FPL (single: up to ~$35,910/yr, family of 4: up to ~$74,250/yr)
Sliding Scale Discounts
225-450% FPL receive partial discounts based on income and household size
85% Self-Pay Discount
All uninsured patients get an automatic 85% off charges, regardless of income
240-Day Application Window
From your first billing statement. 120-day moratorium on collection actions.
Covers Insured Patients Too
Unlike many hospitals, Ballad Health assists insured patients with out-of-pocket costs (deductibles, copays, coinsurance) for income up to 450% FPL.
Eligibility & Income Limits (2026 Federal Poverty Guidelines)
| Income Level (% FPL) | Approximate Income (Single) | Discount |
|---|---|---|
| At or below 225% FPL | Up to ~$35,910/yr | 100% Free Care |
| 226-300% FPL | ~$35,911 - ~$47,880/yr | Significant discount (sliding scale) |
| 301-450% FPL | ~$47,881 - ~$71,820/yr | Partial discount (sliding scale) |
| Above 450% FPL | Above ~$71,820/yr | Not eligible for FA (payment plans available) |
Important Notes
- Both insured and uninsured patients are eligible. Insured patients can get help with deductibles, copays, and coinsurance.
- Eligibility considers income, assets, and liabilities. Only assets convertible to cash and unnecessary for daily living are counted.
- You must apply within 240 days of your first billing statement.
- You have 30 days from application date to submit all supporting documentation.
- Immigration status cannot disqualify you from financial assistance.
- Tennessee law: hospitals cannot charge uninsured patients more than 175% of cost.
85% Automatic Self-Pay Discount
All uninsured/self-pay patients automatically receive an 85% discount off hospital charges, regardless of income. This is separate from the income-based financial assistance program.
How It Works
- The 85% discount is applied automatically to all self-pay accounts.
- No application or income verification is required for this discount.
- If you qualify for income-based financial assistance, it applies to the remaining balance after the self-pay discount.
- Example: A $10,000 bill becomes $1,500 after the 85% discount. If you also qualify for 100% FA, the remaining $1,500 is written off completely.
21 Hospitals Covered (Tennessee & Virginia)
Tennessee Hospitals (13)
Virginia Hospitals (8)
Documents You Will Need
Income Verification
- Last 2 years of federal tax returns
- W-2 forms
- Last 3 pay stubs
- IRS Form 4506-T (if you did not file taxes)
- Social Security, SSI, or SSDI award letters
- Disability, pension, or workers' comp verification
Identity & Household
- Government-issued photo ID
- Documentation for all household members
- Proof of assets (bank statements, investments)
- Insurance card (if applicable)
No income? If you are unemployed with no income, provide a written statement from a physician, pastor, or attorney on their letterhead confirming your situation. Ballad Health also uses presumptive eligibility to automatically qualify certain patients.
How to Apply (Step by Step)
Check Your Eligibility
100% free care at or below 225% FPL (~$35,910/yr single, ~$74,250/yr family of 4). Sliding-scale discounts for 225-450% FPL. All self-pay patients get an automatic 85% discount regardless of income.
Get the Application
Download from balladhealth.org, pick up at any Ballad Health ED or admissions department, or call (888) 288-5174 to request a copy by mail.
Gather Your Documents
Collect 2 years of tax returns, W-2s, last 3 pay stubs, benefit letters, and documentation for all household members. See the full list above.
Submit Your Application
You can submit by:
- Mail: Ballad Health, Attn: Document Imaging, PO Box 746465, Atlanta, GA 30374
- Fax: 980-443-3061
- In person: At any Ballad Health hospital
Follow Up
Call (888) 288-5174 to confirm receipt. Applications are processed within 30-45 days. You have 30 days from the application date to submit all supporting documents, or the account will be released for billing.
Common Pitfalls to Avoid
- Missing the deadline: Apply within 240 days of your first billing statement.
- 30-day document deadline: Submit all supporting documents within 30 days of your application date, or it may be closed.
- Incomplete application: Missing documents delay processing. Gather everything before submitting.
- Forgetting assets: Ballad considers assets as well as income. Be prepared to document bank accounts and investments.
What If You Are Denied?
1. Review the Denial Letter
Ballad Health must provide a written explanation for the denial. Common reasons include income above the threshold, incomplete documentation, or application submitted after the 240-day deadline.
2. File a Formal Appeal
Ballad Health has a dedicated Financial Assistance Appeal Form available on their website. Attach additional documentation supporting your case. Collection actions are suspended during the appeal review.
3. Explore Other Options
- 85% self-pay discount: Even without FA approval, uninsured patients get the automatic 85% discount
- Interest-free payment plans: Minimum $50/month, no interest charged
- Request an itemized bill: Review charges for errors
- TennCare (Medicaid): If you qualify, TennCare may retroactively cover bills
- Virginia Medicaid: Virginia residents may qualify for retroactive coverage
- Undue Medical Debt: Ballad Health has forgiven over $277 million through this program
Let CareRoute Bill Defense Help
If your application was denied or you need help negotiating your Ballad Health bill, CareRoute Bill Defense can review your case and negotiate on your behalf at no upfront cost.
Get Help with Your BillCollections Policy
Aggressive Collection History
Ballad Health filed over 6,700 lawsuits against patients in 2018 alone. The system permits lawsuits, liens, foreclosure, wage garnishment, credit reporting, and debt sales. In 2021, Ballad sold approximately $278 million in outstanding debt to Undue Medical Debt (a nonprofit that abolished the debt), but has not publicly discontinued its litigation practices.
Extraordinary Collection Actions
- Lawsuits: Over 6,700 filed in 2018. No public announcement of discontinuing
- Liens and foreclosure: Policy permits liens on property and foreclosure
- Wage garnishment: Permitted post-judgment in both Tennessee and Virginia (25% of disposable income)
- Credit reporting: Permitted in Tennessee; banned in Virginia (HB 1370, effective July 1, 2024)
- Debt sales: Permitted. Demonstrated by the 2021 Undue Medical Debt transaction
Federal 501(r) requires 30-day oral notice before ECAs and a 240-day notification period from the first billing statement.
Tennessee/Virginia Protections
- Tennessee credit ban (SB 1833): Effective July 1, 2024, healthcare providers cannot report medical debt to credit agencies
- Virginia credit ban (HB 1370): Effective July 1, 2024, medical debt credit reporting prohibited
- Tennessee SOL: 6 years for written contracts
- Virginia SOL: 3 years from due date of final invoice (shortened in 2024)
Already in collections? Read our full 7-step collections playbook for strategies to negotiate, dispute, and resolve medical debt.
Contact Information
Phone Numbers
Hours: Monday-Friday, 8:00 AM - 4:30 PM
Other Ways to Reach Them
State-Specific Protections
Tennessee
- Hospitals cannot charge uninsured patients more than 175% of cost
- No copay required for emergency services
- Immigration status cannot disqualify you
- Statute of limitations on medical debt: 6 years
Virginia
- Hospitals must provide free care to patients at or below 200% FPL
- Medical Debt Protection Act (effective July 1, 2026): no interest or late fees for 90 days, max 3% interest rate
- No ECAs for at least 120 days after final invoice
- 30-day written notice required before any collection action
Frequently Asked Questions
Who qualifies for Ballad Health financial assistance?
Patients with household income at or below 225% FPL (~$35,910/yr for a single person, ~$74,250/yr for a family of 4) qualify for 100% free care. Sliding-scale discounts are available for income up to 450% FPL. Both insured and uninsured patients are eligible.
What is the 85% self-pay discount?
All uninsured/self-pay patients automatically receive an 85% discount off hospital charges, regardless of income. No application is needed. You can still apply for income-based financial assistance on the remaining balance after the discount.
Does Ballad Health cover insured patients?
Yes. Unlike many hospitals, Ballad Health provides financial assistance to insured patients for out-of-pocket costs including deductibles, copays, and coinsurance. You must meet the same income eligibility requirements (up to 450% FPL).
Can I apply after my bill goes to collections?
Yes, as long as you apply within 240 days of your first billing statement. Ballad Health observes a 120-day moratorium on collection actions and will suspend collections during application review. Approved applications reverse collection referrals.
How long does the application process take?
Ballad Health processes complete applications within 30-45 days. You must submit all supporting documentation within 30 days of your application date, or the account may be released for billing. Call (888) 288-5174 to check your status.
What about the $277 million debt forgiveness?
Ballad Health partnered with Undue Medical Debt (formerly RIP Medical Debt) to forgive over $277 million in medical debt for approximately 82,000 patients. This was a one-time program, but Ballad continues to offer robust financial assistance and the 85% self-pay discount.
Need Help with Your Ballad Health Bill?
CareRoute Bill Defense can review your medical bills, identify savings opportunities, and negotiate with Ballad Health on your behalf. No upfront cost.
Start Your Free Case ReviewThis guide is for informational purposes only and does not constitute legal or financial advice. Information is based on publicly available Ballad Health financial assistance policies as of 2026. Eligibility requirements, income thresholds, and application processes may change. Always verify current requirements directly with Ballad Health at (888) 288-5174 or visit balladhealth.org.