skip to main content
Top of main content
AUDIO DESCRIPTIONS

Financial Assistance

Financial Assistance en Espanol

Do You Need Help Paying Your Medical Bill?

Carle Financial Assistance Program, Carle HRHC Financial Assistance Program, and Carle Illinois Hospital Uninsured Patient Discount Program

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.

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*:

  • Carle Foundation Hospital
  • Carle Physician Group
  • Carle Clinic Association
  • Carle Foundation Physician Services
  • Carle Arrow Ambulance
  • Champaign SurgiCenter, LLC
  • Carle SurgiCenter - Danville
  • Carle Medical Supply
  • Carle Home Care
  • Carle Home Care
  • Carle Hospice and Carle Home Infusion
  • Carle Hoopeston Regional Health Center and clinic locations
  • Carle Hoopeston Community Memorial Hospital
  • Charlotte Ann Russell Medical Center
  • Carle Cissna Park
  • Carle Rossville
  • Carle Watseka

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 (English or Spanish), or Carle HRHC Financial Assistance Program Policy.

Submit an Application

You can apply for assistance by:

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: 01/28/2019)
Family Size 138% 200% 300% 400% 600%
1 $17,236 $24,980 $37,470 $49,960 $74,940
2 $23,336 $33,820 $50,730 $67,640 $101,460
3 $29,435 $42,660 $63,990 $85,320 $127,980
4 $35,535 $51,500 $77,250 $103,000 $154,500
5 $41,635 $60,340 $90,510 $120,680 $181,020
6 $47,734 $69,180 $103,770 $138,360 $207,540
7 $53,834 $78,020 $117,030 $156,040 $234,060
8 $59,933 $86,860 $130,290 $173,720 $260,580
Add per each additional person $6,100 $8,840 $13,260 $17,680 $26,520
Program Eligibility Must apply for Medicaid 100% CFAP 50% CFAP & HRHC-IL Uninsured Discount Income Max CAP 40% of income CFH-IL Uninsured Discount Income Max


For more information 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