Financial Assistance

We Are Here to Help

Covenant Health is committed to providing quality health services in a caring environment. It is the expressed philosophy of Covenant Health and our member hospitals that no one should be denied necessary medical care because of the inability to pay.

In support of this philosophy, if you are an uninsured person with no public or private source of payment for medical services, Covenant Health will provide, at a reduced rate, medically indicated services.

To apply for financial assistance, please click the Financial Assistance Application and Instructions link located below (available in English and Spanish), print it, and completely fill out the information. The form also asks for supporting documentation as follows:

• A complete copy of your most recent Income Tax Return and supporting W-2s
• Two (2) current paycheck stubs from adult members of the household
• If you are disabled or retired, send verification of current monthly Social Security and/or retirement benefits (e.g., a letter from Social Security or current bank statement).
• If you are receiving Food Stamps, send verification of benefits.
• If you are not employed, you must provide a dated, notarized letter from the person(s) providing help with living expenses.
• Do not send any bills – only the application and proof of income as listed above.

Thank you in advance for including the required information. Mail your completed financial assistance form and supporting documentation to:

Covenant Health 
Attn: Charity Department 
1420 Centerpoint Blvd. 
Knoxville, TN 37932

If you have additional questions, please call 865-374-3000 Monday through Friday between 8 a.m. and 4:30 p.m.

Financial Assistance Policy

English    Español

Financial Assistance Application and Instructions

English       Español

Plain Language Summary

English       Español

List of Medical Providers’ Coverage by Covenant Health’s Financial Assistance Policy (To determine whether you qualify for financial assistance, please see the Financial Assistance Policy and Financial Assistance Application.)