Financial Assistance

Financial Assistance

Financial Assistance for Those Unable to Pay the Full Cost of Care

CHI Memorial is a part of Catholic Health Initiatives (CHI), a nonprofit health organization with a longstanding commitment to assist those who seek our care, regardless of ability to pay.

If you are unable to pay for all or part of the care you receive from our hospital, you may be eligible for free or discounted services. Please read the information below to understand:

  • How eligibility for financial assistance is determined
  • How to apply for financial assistance.

This information is a summary of the national CHI policy. Please click here to read the policy in full.

PLEASE NOTE: Any patient seeking emergency care will be treated without regard to ability to pay.

How eligibility for financial assistance is determined

To determine your eligibility for financial assistance, we consider:

  1. The medical necessity of services received. In short, medically necessary services save your life, make you well, or prevent a medical condition from becoming worse. There is a detailed definition of medically necessary services in the CHI policy. Medical necessity will be determined by a physician.  In determining medical necessity, we follow all requirements of the federal Emergency Medical Treatment and Active Labor Act and applicable laws and regulations.
  2. Your ability to pay for the services. We look at income, family size, available resources and expected future income (minus living expenses).

You may qualify for 100% of your care provided for free, or a discounted charge under one or both of these criteria:

  • Your family income is low.  Free care may be available to patients with family income less than or equal to 130 percent of the Department of Housing and Urban Development (HUD)very low  income guidelines for the area; and/or
  • You are considered medically indigent. This means that paying the full cost of your medical care, after any health insurance payment, would cause you to become impoverished. This could apply if you are uninsured, underinsured, or suffer a catastrophic illness.

How to apply for financial assistance

When you are registered as a patient, we will ask about your coverage for health care services. If you don’t have coverage or it is not likely to be sufficient, we will either give you a packet of information that covers our financial assistance policy or offer the immediate assistance of a financial counselor, who will go over the financial assistance application with you.

You will need to complete the Financial Assistance Application form or Spanish Financial Assistance Application form, provide all information it requests, and submit it to : Attn: Business Office - Financial Assistance Request, CHI Memorial, 2525 de Sales Avenue, Chattanooga, TN 37404

If it is determined you are eligible for assistance, we will notify you and let you know how much assistance is available. If it is determined you are not eligible for assistance, we will let you know that in writing and give a brief explanation of the reason.

It’s important to note that in accordance with TN Code Annotated, 62-11-262 if you do not have insurance, you will not be required to pay an amount that exceeds one hundred seventy-five percent (175%) of the cost for the services provided, calculated using the cost to charge ratio in the most recent joint annual report.  This amount is generally comparable to the amount for those who have insurance.


Once again, this is a summary of the CHI national financial assistance policy. You can read the full policy here

If you have any questions about qualifying or applying for financial assistance, please call (423) 495-8641 or (423) 495-8632.

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