JACKSON PARK HOSPITAL

CHICAGO, IL · version 1 · published · JSON

eligibility.free_care_max_fpl200% of the federal poverty level

"Full financial assistance, Charity, at a 100% discount of Gross Charges, will be given to patients who have a gross family income equal to or below 200% of the Federal Poverty Levels (FPL), adjusted for family size, provided such patients are not eligible for other private or public health coverage and do not exceed the assets protection threshold."

documented · checked 2026-10-13 · Financial Assistance Policy

eligibility.insured_patients_coveredYes

"Payment Plans. This assists patients with financial needs through payment arrangements. This program is available to both insured and uninsured patients."

documented · checked 2026-10-13 · Financial Assistance Policy

apply.form_urlhttps://www.jacksonparkhospital.org/assets/1/7/Financial%20Assistance%20Application.pdf

"Complete our **[Financial Assistance Form with Instructions](/assets/1/7/Financial_Assistance_Guidelines_Packet.pdf)**"

documented · checked 2026-10-13 · Financial Assistance Program | jacksonparkhospital

apply.documents_requiredPhoto ID
Proof of income
Social Security letter
Tax return
Pay stubs
Bank statements

"PROOF OF INCOME: In order to establish your Annual Net Income, the following documents are required.  Last four (4) pay stubs, yearly ledger to date if self-employed and/or proof of child support  Three most recent bank statements  Copy of last year’s W2 forms  Copy of last year’s complete tax form  Room and Board Letter if applicable or Rent Receipt  Drivers License (Photo I.D.)  Social Security Card"

documented · checked 2026-10-13 · FINANCIAL ASSISTANCE ELIGIBILITY GUIDELINES Dear ...

contacts.phone773-947-7500 x7996

"You can call 773-947-7500 x7996 to ask that a copy of any of the above be sent to you free of charge by mail or email."

documented · checked 2026-10-13 · Financial Assistance Policy

contacts.hoursSunday - Saturday 8:00am - 11:00pm

"QUESTIONS? Please feel free to call our office Sunday - Saturday 8:00am - 11:00pm at (773) 947-7500 ext. 7996 or 7997"

documented · checked 2026-10-13 · FINANCIAL ASSISTANCE ELIGIBILITY GUIDELINES Dear ...

contacts.languagesEnglish
Spanish

"This policy and our Financial Assistance Application are available in other languages in accordance with the applicable "Standards for Culturally and Linguistically Appropriate Services in Health Care" (Standards 4 & 7, based on Title VI of the Civil Rights Act of 1964)."

documented · checked 2026-10-13 · Financial Assistance Policy

Sources

Financial Assistance Policy — fetched 2026-10-13

FAP Plain Language Summary.pdf — fetched 2026-10-13

Financial Assistance Program | jacksonparkhospital — fetched 2026-10-13

FINANCIAL ASSISTANCE ELIGIBILITY GUIDELINES Dear ... — fetched 2026-10-13