A charity is wiping out $278 million worth of medical debt, a stroke of philanthropy that will impact 82,000 low-income patients in Tennessee and Virginia. Some of the debt is over a decade old.

According to The Wall Street Journal, RIP Medical Debt has settled the unpaid bills with Ballad Health, a nonprofit hospital system. Terms of the deal were not disclosed, but it’s common for third parties to buy medical debt for pennies on the dollar.

In some zip codes where Ballad is most dominant, as many as 1 in 5 residents will be impacted. They’ll be notified later this month.

Many patients who were burdened with medical bills from Ballad should have received free health care or government subsidies, but they didn’t know they were eligible. In a recent IRS filing, Ballad estimates that $49.6 million of outstanding debt was accrued by patients who were eligible for financial aid but did not apply.

More from The Wall Street Journal:

The deal highlights gaps in financial-aid programs by nonprofit hospitals, which get federal, state and local tax breaks in exchange for giving back to their communities. State attorneys general, lawmakers and patient advocates have faulted hospitals for aid programs they say are hard to apply for and poorly promoted.

“Often you’ll see, ‘You might be eligible for financial assistance’ in tiny print, but it’s pretty hard to find,” said Elisabeth Benjamin, vice president of health initiatives at the Community Service Society of New York. “It’s like playing ‘Where’s Waldo.’”

Allison Sesso, RIP Medical Debt’s executive director, said her organization plans to purchase more debt directly from hospitals.