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:
- 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.
- We will approve and apply discounts only after all third-party payments have been received.
- 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.
- Discounts will extend for one year from the date of approval. To continue to receive financial assistance, a new application must be submitted yearly.
- These programs are open to new and existing patients who meet certain residency requirements.
- 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.
- Carle staff will review your application and if approved, match you with the assistance program that is best for you.
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 Therapy Services
- Carle Medical Supply
- 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
- Carle Milford
- Carle Danville on Fairchild
- Carle Mattoon on Hurst
- Carle Tuscola
*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 HRHC Financial Assistance Program Policy.
Other related links
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: 1/22/2018)
For more information
||Federal Poverty level income max
|Add per each additional person
||Must apply for Medicaid
||50% CFAP & HRHC-IL Uninsured Discount Income Max
||CAP 40% of income
||CFH-IL Uninsured Discount Income Max
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