OSF HOLY FAMILY MEDICAL CENTER

"Charity Care/Full Coverage (100% Discount): Available to individuals or families with income at or below 350% of the Federal Poverty Level (FPL). Eligible patients may receive a 100% write-off of the portion of charges they are responsible for."

documented · checked 2026-10-14 · [PDF] Financial Assistance & Charity Care Program

"Along with the application, please provide a copy of at least one of the following items as your proof of income: • Two (2) most recent paystubs from employer • Most recent yearly tax return (if self-employed, include all schedules) • Social Security and/or Pension Retirement Award Letter • Parent/Guardian’s most recent yearly tax return (if applicant is a dependent listed on their tax form and under the age 25) • Other income validation documents • Bank statements from last 3 months • Receipt of unemployment benefits"

documented · checked 2026-10-14 · Financial Assistance Program – Application

"Please complete this application and submit it to Holy Family Medical Center by mail, by electronic mail (email), or by fax to apply for free or discounted care as soon as possible after the date of service."

documented · checked 2026-10-14 · Financial Assistance Program – Application

"We will accept your application for up to 240 days following the first billing statement for your care."

documented · checked 2026-10-14 · Financial Assistance Program – Application

"call our Patient Financial Services at [773-990-3289](tel:773-990-3289)."

documented · checked 2026-10-14 · Financial Assistance - Holy Family Medical Center

"Financial assistance documents, including the policy, this plain language summary and application, are available in multiple languages and can be found on our website at: https://holyfamilymedicalcenter.com/financial-assistance/."

documented · checked 2026-10-14 · [PDF] Financial Assistance & Charity Care Program

"River Road, Des Plaines, IL 60016"

documented · checked 2026-10-14 · [PDF] Financial Assistance & Charity Care Program