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Financial Assistance

At Carle, we believe that the cost of healthcare should not stop anyone from receiving necessary care. Complete a financial assistance application today. Charity Care

Financial Assistance en Espanol

Do You Need Help Paying Your Medical Bill?

At Carle, we believe that the cost of healthcare should not stop anyone from receiving necessary care. Our patients may be able to receive free or discounted care through one of our financial assistance programs.

Completing a financial assistance application will help Carle determine if you can receive free or discounted services.

Here Are Some General Guidelines About the Program:

  1. Eligibility is based on your household's adjusted gross income as reported on the prior year's Federal Tax Return and family size. If you are claimed as a dependent on another's Federal Tax Return, you will need to submit their Federal Tax Return as well.
  2. We will approve and apply discounts only after all third-party payments have been received.
  3. Before granting discounted care, we may ask you to apply for public assistance. Carle's Case Management department will be happy to help you fill out application forms.
  4. Discounts will extend for one year from the date of approval. To continue to receive financial assistance, a new application must be submitted yearly.
  5. These programs are open to new and existing patients who meet certain residency requirements.
  6. Uninsured hospital patients who meet certain requirements may qualify for an uninsured discount through Carle's Illinois Hospital Uninsured Patient Discount Program and your qualified hospital expenses may be limited to 25% of your annual gross income.
  7. Carle staff will review your application and if approved, match you with the assistance program that is best for you.
  8. Carle reserves the right to require patients to produce additional information in order to verify income and/or assets.

Eligible Services

Eligible Services are those services provided in accordance with the generally accepted standards of medical practice by one of the following Carle entities*:

  • Arrow Ambulance, LLC
  • Carle Foundation Hospital 
  • Carle Home Care 
  • Carle Home Infusion 
  • Carle Hospice
  • Carle Medical Supply 
  • Carle Physician Group
  • Carle SurgiCenter - Danville, a Department of Carle Foundation Hospital 
  • Champaign SurgiCenter, LLC
  • Carle Therapy Services

  • Carle Hoopeston Regional Health Center and Clinic Locations: 
    • Carle Cissna Park
    • Carle Danville on Fairchild
    • Carle Mattoon on Hurst
    • Carle Milford
    • Carle Rossville
    • Carle Tuscola
    • Carle Watseka
    • Charlotte Ann Russell Medical Center
    • Hoopeston Community Memorial Hospital

  • Carle Richland Memorial Hospital and Clinic Locations: 
    • Carle Bridgeport
    • Carle Newton
    • Carle Olney - Family Practice Clinic
    • Carle Olney - Primary Care Clinic
    • Carle Richland Memorial Hospital
    • Carle West Salem 

  • Carle BroMenn Medical Center and Clinic Locations: 
    • Carle West Physician Group
    • Carle BroMenn Outpatient Center
    • The Center for Outpatient Medicine
    • Community Cancer Center

  • Carle Eureka Hospital and Clinic Locations: 
    • Carle Eureka
    • Carle El Paso 







Additional Providers

*Additional providers may provide services at a Carle location who are not participating under the CFAP. View complete listing of participating and non-participating providers.

For further details about the Carle Financial Assistance Programs, read the Plain Language Summary, Carle Financial Assistance Program Policy, or Carle Regional Financial Assistance Program Policy.

Submit an Application

You can apply for assistance by:

  • Completing an application online
  • Downloading an application here—in English and En Español.
  • Obtaining a financial assistance application at any of our registration desks throughout our facilities and clinics
  • Requesting an application be mailed to you by – Calling Patient Financial Services at (888) 71-CARLE, (888) 712-2753, or – writing Carle Financial Assistance Program at PO Box 4024, Champaign, IL 61824-4024.

Once completed, you can mail your application to Carle Patient Financial Services, PO Box 4024, Champaign, IL 61824-4024. You may also come by and drop it off at any Carle front desk or office at the Hospital or within any of our clinics.

Eligibility will be determined once a completed application is received by Carle. Staff will review your application, and if approved, match you with the most beneficial financial assistance program at Carle. Patients will not be charged more for care than Amounts Generally Billed (AGB) to those patients who have insurance.

 

 

Discount Table (Carle Effective Date: 03/01/2023)
Family Size 200% 300% 400% 600%
1 $29,160 $43,740 $58,320 $87,480
2 $39,440 $59,160 $78,880 $118,320
3 $49,720 $74,580 $99,440 $149,160
4 $60,000 $90,000 $120,000 $180,000
5 $70,280 $105,420 $140,560 $210,840
6 $80,560 $120,840 $161,120 $241,680
7 $90,840 $136,260 $181,680 $272,520
8 $101,120 $151,680 $202,240 $303,360
Add per each additional person $10,280 $15,420 $20,560 $30,840
Program Eligibility 100% CFAP CFAP 50% and CHRHC/CRMH IL Uninsured Discount Income Max CAP 40% of income CFH/CBMC/CEH IL Uninsured Discount Income Max

Amounts Generally Billed (AGB) to Carle Financial Assistance Program participants will be determined by Medicare fee-for-service together with all private health insurers, during a prior 12-month period.

1. AGB determined through calculations of sum of all payments plus the sum of all bad debt and charity care adjustments divided by the sum of all charges in the time frame.

2. Time frame included in method is for October 1 through September 30 of the prior calendar year.

It’s our goal to help you understand your financial assistance options and to help whenever possible. If you have questions, please call Carle Patient Financial Services at (888) 71-CARLE, (888) 712-2753.

Carle Financial Assistance Program PO Box 4024 Champaign, IL, 61824-4024 Phone: (888) 71-CARLE, (888) 712-2753. Fax: (217) 902-7720 Email: FinancialAssistance@carle.com