# Appalachian District Health Department

Health center organization in Jefferson, NC. The federal rule for health centers.

Appalachian District Health Department charges a lower, sliding fee based on income to patients whose household has a yearly income up to $31,920 for 1 person, $43,280 for 2, $54,640 for 3, $66,000 for 4, $77,360 for 5 or $88,720 for 6. Federal health center rules require this sliding fee at or below 200% of the federal poverty level. Ask the front desk for the sliding fee application.

The hospital makes the final decision.

| Household size | Free care if yearly income is up to | Discount if yearly income is up to |
|---|---|---|
| 1 | not found | $31,920 |
| 2 | not found | $43,280 |
| 3 | not found | $54,640 |
| 4 | not found | $66,000 |
| 5 | not found | $77,360 |
| 6 | not found | $88,720 |

Dollar amounts use the 2026 federal poverty guidelines.

## How to apply

- Call (336) 246-9449 and ask for financial assistance.
- [Health center website](https://www.apphealthcare.com)

## Sites

- AppHealthCare -Ashe Health Center, 413 McConnell St, Jefferson, NC 28640, (336) 246-9449
- Appalachian District Health Department Dental Center, 225 Court St, Jefferson, NC 28640, 336-264-9449 x2131
- Appalachian District Health Center - Alleghany County, 157 Health Services Rd, Sparta, NC 28675, (336) 372-5641

## State program in North Carolina

### North Carolina Medical Debt Mitigation Program (NCDHHS, through the Medicaid HASP program)

North Carolina's acute care hospitals agreed with the state health department (NCDHHS) to follow set charity care rules in return for higher Medicaid payments. Every eligible hospital signed on. For North Carolina residents, hospital bills are 100% discounted below 200% of the federal poverty level. Between 200% and 250% the discount is at least 75%. Between 250% and 300% it is at least 50%. The discounts apply to insured and uninsured patients, but hospitals do not have to discount insurance copays. For emergency room care, a hospital may still charge a small fee of up to $35. Since January 1, 2026, hospitals must screen patients and give these discounts without an application when household income looks to be at or below 300% of the poverty level. You may also apply yourself. The rules cover the hospital's own bill, not separate doctor or pharmacy bills. This is a state program agreement, not a state law.

Income levels in the program are free up to 200%, discount up to 300% of poverty level.

Applies to the acute care and critical access hospitals on NCDHHS's list of participating hospitals; North Carolina residents (hospitals may choose to help non-residents).

How to apply. Most patients should be screened automatically. You can also ask the hospital's financial assistance office to apply under its Medical Debt Mitigation Policy. Each hospital's policy is linked from NCDHHS at https://www.ncdhhs.gov/hospital-financial-assistance-policies/open. Questions: NCDHHS Customer Service Center, 1-800-662-7030.

> Discount of 100% for individuals with incomes below 200% FPL.

Source https://www.ncdhhs.gov/medical-debt-toolkit/download?attachment, checked 2026-11-11

## Sources

No source yet beyond the federal rule. The hospital's own policy is the final word.

Not checked yet.

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