CARLE HEALTH PROCTOR HOSPITAL
PEORIA, IL · version 3 · published · JSON
eligibility.free_care_max_fpl200% of the federal poverty level"0-200% of FPIG: 100% discount off AGB"
documented · checked 2026-10-10 · Title: Financial Assistance – Hospital Facilities 1.BR.34
eligibility.discount_tiersAbove 200% up to 225% of FPL: 65% discountAbove 225% up to 250% of FPL: 45% discount
Above 250% up to 300% of FPL: 25% discount
Above 300% up to 400% of FPL: 5% discount
"0-200% of FPIG: 100% discount off AGB 201-225% of FPIG: 65% discount off AGB 226-250% of FPIG: 45% discount off AGB 251-300% of FPIG: 25% discount off AGB 301-400% of FPIG: 5% discount off AGB"
documented · checked 2026-10-10 · Title: Financial Assistance – Hospital Facilities 1.BR.34
eligibility.insured_patients_coveredYes"Financial Assistance will be offered for eligible patients to cover patient responsibility for uninsured patients as well as patients with balances remaining after insurance payment."
documented · checked 2026-10-10 · Title: Financial Assistance – Hospital Facilities 1.BR.34
apply.documents_requiredProof of residency"An IL CHWR Hospital may require an Uninsured Patient who is requesting an uninsured discount to certify the existence, or absence of, assets owned by the Uninsured Patient and to provide documentation of the value of such assets, except for Uninsured Patient’s primary residence;"
documented · checked 2026-10-10 · Title: Financial Assistance – Hospital Facilities 1.BR.34
apply.submit_methodsMail: Central Billing Office, ATTN: FA Team, P.O. Box 35758, Des Moines, IA 50315-4205Email: FA_CBO_Request@unitypoint.org
Fax: (515) 362-5055
In person: submit to the hospital in person
"Important: YOU MAY BE ABLE TO RECEIVE FREE OR DISCOUNTED CARE: Completing this application will help Carle Health – West Region determine if you can receive free or discounted services or other public programs that can help pay for your healthcare. Please submit this application in one of the following manners: If by mail, to the following address: Central Billing Office, ATTN: FA Team, P.O. Box 35758, Des Moines, IA 50315-4205 If by email, to FA_CBO_Request@unitypoint.org If by fax, to (515) 362-5055. Write “FA Application” on fax cover sheet. IF YOU ARE UNINSURED, A SOCIAL SECURITY NUMBER IS NOT REQUIRED TO QUALIFY FOR FREE OR DISCOUNTED CARE. However, a Social Security Number is required for some public programs, including Medicaid. Providing a Social Security Number is not required but will help the hospital determine whether you qualify for any public programs. Please complete this form and submit to the hospital in person, by mail, by electronic mail, or by fax to apply for free or discounted care within 60 days following the date of discharge or receipt of outpatient care."
documented · checked 2026-10-10 · Title: Financial Assistance – Hospital Facilities 1.BR.34
Sources
Carle Financial Assistance Programs — fetched 2026-10-10
Answers to Frequently Asked Billing Questions - FAQs | Carle.org — fetched 2026-10-10
Title: Financial Assistance – Hospital Facilities 1.BR.34 — fetched 2026-10-10
Financial Assistance - Apply Today | Carle Health — fetched 2026-10-10
Financial Assistance en Espanol — fetched 2026-10-10
Carle Rural Health Financial Assistance Program — fetched 2026-10-10