Patient Financial Assistance
You may be eligible for financial assistance under the terms and conditions the hospital offers to qualified patients. For more information contact the Hospital's Patient Financial Counselor in person, by phone at 618-357-5906 or by email at firstname.lastname@example.org.
Financial Need Program: Applications are available upon request if you are uninsured and need assistance in paying balances due for Hospital Inpatient and Outpatient services and for Family Medical Center visits. Insured individuals with catastrophic medical and financial situations may also be eligible. Based upon supporting documentation provided and if the patient's household income is below 200% of the Federal Poverty Level (per 2015 levels, a family of four making less than $48,500 per year), you may be eligible for a full or partial reduction of the balance you owe. Patients may be required to first apply for Medicaid.
Illinois Uninsured Patient Discount Act: An uninsured patient who meets certain income requirements may qualify for an uninsured discount. The patient must be an Illinois resident and not covered under any health insurance policy, including high deductible health plan, work comp or accident liability insurance. The patient must have household income at or below 300% of the Federal Poverty Level (per 2016 levels, a family of four making $72,900.00 or less). The patient must submit a completed application within 60 days from the date of service. If the submitted application is incomplete, the patient has an additional 30 days from the date of request to supply required documentation. If deadlines are not met, the patient forfeits eligibility for the Uninsured Patient Discount but may still qualify under the Hospital's Financial Need Program if household income is below 200% of the Federal Poverty Level (per 2016 levels, a family of four making less than $48,600.00 per year). If the patient qualifies for the Uninsured Patient Discount, the patient's bill will be discounted and the maximum amount owed by the patient will be 135% of the hospital's cost for services.
The Patient Financial Assistance Application is available via the website link below or upon request by contacting the Patient Financial Counselor.
Patient Financial Assistance Application