The philosophy of OSF HealthCare is that all people have a right to receive needed health care. Our doors are open to persons of every faith and ethnic background regardless of their ability to pay.
|Application - English (PDF - 1.3 MB)|
|Application - Español (PDF - 1.0 MB)|
We provide help to patients in obtaining payment from third parties such as Medicaid and Medicare. If you are eligible for Medicaid, and you are not currently signed up, we can help you apply.
We also offer financial assistance for medically necessary health care services to persons who meet our financial terms provided they submit the necessary documents.
OSF Financial Assistance may be applied for when there is a balance still due on an account after we have received payment from third party payers (like Medicaid, Medicare or an insurance company) and you feel you cannot pay the full balance.
The PDF form of the Financial Assistance Application offered here must be completed and signed by you. We use income guidelines established by the U.S. Department of Health and Human Services to determine if you are eligible for charity care.
So, please provide all the information promptly so we may try to help you as quickly as possible.
If you have questions, please call a patient services representative toll-free at (800) 421-5700.
Call Center Hours
|Monday - Friday||8 a.m. - 4:30 p.m.|