Let’s work together on the details.
As a not-for-profit, faith-based organization, we’re dedicated to providing care regardless of our patients’ ability to pay.
We offer a variety of financial assistance programs to help those who have difficulty paying medical bills.
Your financial circumstances will not affect the care you receive. We treat every patient with dignity, respect and compassion.
Offers free or discounted care based on family size and income according to the Federal Poverty Guidelines (FPG). Available to uninsured and underinsured patients. To apply, complete the Financial Assistance Program Application.
Automatic Uninsured Self-Pay Discount
Provides an automatic 40% discount to uninsured patients for all medically necessary health care services. No application necessary. Those who receive a pre-negotiated discount will not be eligible.
Limits out-of-pocket costs over a 12-month period for medically necessary services when it exceeds 15% of your family’s gross income. Available to uninsured and insured patients. To apply, complete the Financial Assistance Program Application.
Assists patients with financial needs through payment arrangements. Available to both uninsured and insured patients. One of our financial counselors will help you set up a payment plan.
If you do not qualify for assistance but believe you have special circumstances, you can request a review by the hospital’s financial assistance committee.
You may also be eligible for public programs such as Medicaid, Medicare or All Kids. Applying for such programs may be required before requesting financial assistance.
Request an application.
Find forms at the hospital or online.
Fill out and return.
Complete the application and any supporting documents and return to the hospital or mail to:
1000 Remington Blvd., Suite 110
Bolingbrook, Illinois 60440
We review your application.
We will go over your application to see if you qualify based on the guidelines in this brochure. If there are special circumstances that affect your ability to pay, these may be reviewed by the hospital’s financial assistance committee.
You receive an answer.
We will send you a written decision within 45 days. If your request is denied, you will be given an explanation and information on setting up a payment plan and how to appeal the decision, if applicable.
If you have already qualified for a government sponsored program, such as food stamps or subsidized housing, you will be presumed eligible for assistance from us. No application necessary. Just supply us with verification that you are enrolled.
All applications for financial assistance are kept completely private. The information you provide is shared only with those responsible for determining your eligibility.
Find out whether or not you may qualify for financial assistance by looking at the chart below. Find your family size in the first column and then look right to see which category your household income falls under. This will tell you what percentage of financial assistance you may qualify for.
To qualify for 100% financial assistance, your household income must be at or below 200% of the current Federal Poverty Guidelines (FPG). Uninsured patients who meet this requirement will receive a full write-off of charges.
Insured patients who have an income below 200% of the FPG may also qualify, but must first cover any copayments or coinsurance up to $300 per episode of care.
Partial financial assistance
To qualify for partial financial assistance, your household income must be between 200% and 600% of the current FPG. For uninsured patients who meet this requirement, a sliding scale is used to determine a discount percentage on charges.