Financial Assistance en Espanol
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.
Eligible Services are those services provided in accordance with the generally accepted standards of medical practice by one of the following Carle entities*:
*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.
You can apply for assistance by:
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.
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