Vanderbilt University Medical Center Financial Assistance: Free Care to 200% FPL + Discounts to 400% FPL (2026 Guide)
Vanderbilt University Medical Center (VUMC) provides financial assistance to patients who cannot afford their medical bills. Patients with household income at or below 200% of the Federal Poverty Level qualify for 100% free care, and those between 201-400% FPL receive sliding-scale discounts. The policy covers Vanderbilt University Hospital, Monroe Carell Jr. Children's Hospital, and all VUMC-affiliated facilities across Middle Tennessee. Tennessee law also caps uninsured patient charges at 175% of cost.
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Quick Facts
100% Free Care
Household income at 0-200% FPL (single: up to ~$31,920/yr) qualifies for full charity care covering all eligible services
Sliding Scale to 400% FPL
Income between 201-400% FPL receives percentage-based discounts on a sliding fee schedule based on income and family size
88% AGB Discount
VUMC's AGB is just 12% of billed charges, meaning eligible patients receive a minimum 88% discount off total billed facility charges
TN 175% Cost Cap
Tennessee law (TCA 68-11-262) prohibits hospitals from charging uninsured patients more than 175% of the cost of services provided
Monroe Carell Jr. Children's Hospital Included
All financial assistance policies apply equally to Monroe Carell Jr. Children's Hospital at Vanderbilt. As a nonprofit children's hospital, Monroe Carell cares for children regardless of ability to pay. The same application process and income thresholds apply.
Eligibility & Income Limits (2026 Federal Poverty Guidelines)
| Income Level (% FPL) | Approximate Income (Single) | Discount Level |
|---|---|---|
| 0-200% FPL | Up to ~$31,920/yr | 100% Free Care |
| 201-300% FPL | ~$31,921 - ~$47,880/yr | Significant sliding-scale discount |
| 301-400% FPL | ~$47,881 - ~$63,840/yr | Partial sliding-scale discount |
| Above 400% FPL | Above ~$63,840/yr | May still qualify if uninsured (TN 175% cost cap applies) |
Important Notes
- Both insured and uninsured patients may qualify for financial assistance.
- Eligibility is based on adjusted gross income of the patient (or household if filing jointly) for the current or prior year compared to Federal Poverty Guidelines.
- Uninsured patients should apply for TennCare (Tennessee Medicaid) first if income is below 138% FPL.
- Tennessee law caps charges to uninsured patients at 175% of the cost of services (TCA 68-11-262).
- VUMC will never charge FA-eligible patients more than Amounts Generally Billed (AGB) to insured patients (currently 12% of billed charges, or an 88% discount).
- Financial assistance covers medically necessary services provided at VUMC facilities.
Tennessee Context: TennCare and the 175% Cost Cap
Tennessee 175% Cost Cap (TCA 68-11-262)
Tennessee law prohibits hospitals from charging uninsured patients more than 175% of the cost of services provided. This applies to all Tennessee hospitals, ambulatory surgery centers, and outpatient diagnostic centers, including Vanderbilt.
Who Benefits from the 175% Cap?
- Uninsured patients with no public or private source of payment
- This includes patients without Medicare, TennCare, private insurance, or any employer-sponsored health plan
- The cap is calculated using the hospital's cost-to-charge ratio from the most recent joint annual report
- This protection is automatic and applies regardless of income level
TennCare (Tennessee Medicaid)
TennCare covers eligible adults and children in Tennessee. If you are uninsured and your income is below 138% FPL (~$22,024/yr single), apply for TennCare first. If approved, TennCare will cover your Vanderbilt bills directly. VUMC customer service representatives can help you with TennCare applications and connect you to government-sponsored programs.
Check both programs: You may benefit from the Tennessee 175% cost cap AND VUMC's financial assistance policy. These protections work independently. The financial assistance program often provides even greater savings than the state cost cap alone.
VUMC Hospitals and Facilities
Major Hospitals
Clinics and Outpatient Facilities
The VUMC Financial Assistance Policy applies to all Vanderbilt University Medical Center facilities. Some independently billing physicians (such as certain specialists) may have separate policies. Always confirm coverage when scheduling. Note: Vanderbilt Stallworth Rehabilitation Hospital (operated by Encompass Health) has its own financial assistance policy.
Documents You Will Need
Income Verification
- Recent pay stubs (most recent 30 days)
- Most recent federal tax return
- Benefit letters (Social Security, disability, unemployment)
- Self-employment income documentation
- Income for all household members
Other Documentation
- Government-issued photo ID
- Proof of Tennessee residency (if applicable)
- Insurance information (if applicable)
- Completed VUMC Financial Assistance Application
- Bank statements (may be requested)
Important: Incomplete applications can delay or prevent approval. Make sure every required field is filled out and all supporting documents are included before submitting.
How to Apply (Step by Step)
Check Your Eligibility
100% free care at 0-200% FPL (~$31,920/yr single). Sliding-scale discounts at 201-400% FPL (~$63,840/yr single). If uninsured, the Tennessee 175% cost cap also applies regardless of income.
Contact VUMC Customer Service
Call (615) 936-0910, Monday through Friday, 8am to 5pm. A customer service representative can walk you through the process, help determine which programs you qualify for, and assist with TennCare or other government program applications.
Complete the Application
Download the VUMC Financial Assistance Application from vanderbilthealth.com/information/financial-assistance, or request one by phone. Fill out completely with household income and family size information.
Submit Your Application
You can submit by:
- Mail: VUMC Patient Financial Services, Nashville, TN
- In person: Financial counseling at any VUMC facility
- Email: financial.assistance@vumc.org
Follow Up
Call (615) 936-0910 to confirm receipt and check status. Keep copies of everything you submit. You can also email financial.assistance@vumc.org for updates.
Common Pitfalls to Avoid
- Missing the deadline: Apply as soon as possible after receiving your bill. Do not wait until the account goes to collections.
- Incomplete application: Missing documents or blank fields will delay your application. Double-check before submitting.
- Skipping TennCare screening: Uninsured patients with income below 138% FPL should apply for TennCare first, as VUMC may require this before processing FA.
- Not asking about the AGB discount: Even if you do not qualify for full free care, the 88% AGB discount may dramatically reduce your bill.
- Assuming physicians are covered: Some Vanderbilt physicians bill independently and may have separate financial assistance policies. Confirm coverage for each provider.
Struggling with a Vanderbilt Bill?
CareRoute Bill Defense can review your Vanderbilt bill for errors, identify financial assistance you may be missing, and negotiate directly with VUMC on your behalf. No upfront cost.
Get Help with Your Vanderbilt BillPayment Plans
VUMC Payment Plans
- Available to any patient with a balance after financial assistance determination
- Customer service representatives can set up plans by phone
- Call (615) 936-0910, Monday through Friday, 8am to 5pm
- Terms based on balance amount and ability to pay
- Designed to be affordable based on your financial situation
Tips for Payment Plans
- Always apply for financial assistance first, as this reduces the total balance before setting up payments
- Ask for the lowest monthly payment available
- Request that no interest be charged on the payment plan
- Get the payment plan agreement in writing
- Set up automatic payments to avoid missed payments
Collection Practices: What to Know
Your Protections
- VUMC must provide written notice of the financial assistance policy before pursuing collections
- As a nonprofit hospital, VUMC is required by federal law (IRS Section 501(r)) to make reasonable efforts to determine FA eligibility before extraordinary collection actions
- Tennessee's 175% cost cap applies to all uninsured patient charges regardless of collection status
What May Happen with Unpaid Bills
- VUMC will send billing statements and contact attempts before escalating
- Accounts may be placed with collection agencies if left unresolved
- You can apply for financial assistance at any point during the billing process
Apply for financial assistance as soon as possible. Do not ignore bills. Contact VUMC at (615) 936-0910 if you cannot afford your bill.
What If You Are Denied?
1. Ask Why and Reapply
Call (615) 936-0910 to learn the specific reason for denial. Common reasons include income above the threshold, incomplete documentation, or missing information. You can reapply with corrected or additional documentation.
2. Request the 175% Cost Cap
If you are uninsured and were denied FA, you are still protected by Tennessee's 175% cost cap. Ask VUMC to apply the TCA 68-11-262 cost cap to your bill. This limits charges to 175% of the actual cost of providing services.
3. Explore Other Options
- TennCare: Apply if your income is below 138% FPL
- Payment plans: Request an affordable monthly payment arrangement
- Request an itemized bill: Review all charges for errors or duplicate billing
- Dollar For: Nonprofit that helps patients apply for charity care (dollarfor.org)
- Tennessee Hospital Association: Can help with complaints about billing practices
Let CareRoute Bill Defense Help
If your application was denied or you need help negotiating your Vanderbilt bill, CareRoute Bill Defense can review your case and negotiate on your behalf at no upfront cost.
Get Help with Your BillContact Information
Customer Service
Monday through Friday: 8:00 AM - 5:00 PM CT
Online Resources
Frequently Asked Questions
Who qualifies for Vanderbilt financial assistance?
Patients with household income at or below 200% FPL (~$31,920/yr single) qualify for 100% free care. Those between 201-400% FPL get sliding-scale discounts based on income and family size. Both insured and uninsured patients may apply.
What is the AGB discount at Vanderbilt?
As of 2026, the Amounts Generally Billed (AGB) percentage for VUMC is 12% of total billed facility charges. This means eligible financial assistance patients receive a minimum 88% discount off billed charges. The AGB ensures you are never charged more than what insured patients pay on average.
Does Tennessee have a cost cap for uninsured patients?
Yes. Under Tennessee Code 68-11-262, hospitals cannot charge uninsured patients more than 175% of the cost of services provided. This applies to all Tennessee hospitals including Vanderbilt, calculated using the cost-to-charge ratio in the most recent joint annual report.
Is Monroe Carell Jr. Children's Hospital covered?
Yes. Monroe Carell Jr. Children's Hospital at Vanderbilt is fully covered by VUMC's financial assistance policy. The same application process and income thresholds apply. As a nonprofit children's hospital, Monroe Carell provides care regardless of ability to pay.
Can I get help with my Vanderbilt bill if I have insurance?
Yes. Both insured and uninsured patients may qualify for VUMC financial assistance. Insured patients can receive help with out-of-pocket costs including deductibles, copays, and coinsurance after insurance has paid its portion.
How long does the financial assistance application process take?
Processing times vary, but you should hear back within a few weeks of submitting a complete application. Call (615) 936-0910 to check status. If you submit an incomplete application, it will take longer as VUMC will need to request additional documentation.
Related Resources
Need Help with Your Vanderbilt Bill?
CareRoute Bill Defense can review your medical bills, identify savings opportunities, and negotiate with Vanderbilt 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 Vanderbilt University Medical Center financial assistance policies as of 2025-2026. Eligibility requirements, income thresholds, and application processes may change. Always verify current requirements directly with VUMC at (615) 936-0910 or visit vanderbilthealth.com/information/financial-assistance.