HILLSBORO AREA HOSPITAL

HILLSBORO, IL · version 1 · published · JSON

eligibility.free_care_max_fpl200% of the federal poverty level

"Family Income as a % of Federal Poverty Level % of Balance to be written off 0% - 200% 100%"

documented · checked 2026-10-13 · Download the Charity Care Uninsured Financial Assistance Policy

eligibility.discount_tiersAbove 200% up to 210% of FPL: 90% discount
Above 210% up to 220% of FPL: 80% discount
Above 220% up to 230% of FPL: 70% discount
Above 230% up to 240% of FPL: 60% discount
Above 240% up to 250% of FPL: 50% discount
Above 250% up to 260% of FPL: 40% discount
Above 260% up to 270% of FPL: 30% discount
Above 270% up to 300% of FPL: 20% discount

"Family Income as a % of Federal Poverty Level % of Balance to be written off 0% - 200% 100% 201%-210% 90% 211%-220% 80% 221%-230% 70% 231% - 240% 60% 241% -250% 50% 251% - 260% 40% 261% -270% 30% 271% -300% 20%"

documented · checked 2026-10-13 · Download the Charity Care Uninsured Financial Assistance Policy

eligibility.insured_patients_coveredNo

"Uninsured Discount Patients who do not have insurance and do not qualify for Medicaid may be eligible for an uninsured discount under specific terms and conditions."

documented · checked 2026-10-13 · Financial Assistance

programs.presumptiveDeceased with no estate
Homelessness
Mental incapacitation with no one to act on patient’s behalf

"Presumptive Eligibility: The following criteria will be used to determine if a patient is eligible for financial assistance without further inquiry by Hillsboro Health. These categories will reflect the free care mandate included in the 2012 Amendment to the Hospital Uninsured Patient Discount Act (HUPDA) legislation for uninsured patients. a) Deceased with no estate b) Homelessness c) Mental incapacitation with no one to act on patient’s behalf d) Patients who have active IL Medicaid eligibility, but not on the date of service or for non-covered services e) Uninsured inmates incarcerated in a penal institution on the date of service if the visit is not a result of an injury in the penal institution"

documented · checked 2026-10-13 · Download the Charity Care Uninsured Financial Assistance Policy

apply.form_urlhttps://www.hillsborohealth.org/sites/default/files/2024-07/2024%20Financial%20Assistance%20App.pdf

"[Download our financial assistance/uninsured application](https://www.hillsborohealth.org/sites/default/files/2024-07/2024%20Financial%20Assistance%20App.pdf)"

documented · checked 2026-10-13 · Financial Assistance

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

"Complete the Financial Assistance/Uninsured Application and return it along with: ### Proof of family income for the last three (3) months. * Copies of pay stubs or a statement signed by your employer * Copy of social security, disability, pension income * Copy of unemployment or worker's compensation income * Copy of child support income * Copy of your most recent year's Federal income tax return or W-2 ### Proof of residency (for uninsured discount only) * Driver's license * State-issued identification card * Recent residential utility bill * Lease agreement * Voter registration card * Letter from a homeless shelter, transitional house or other similar facility verifying that the uninsured patient resides at the facility"

documented · checked 2026-10-13 · Financial Assistance

apply.submit_methodsIn person: Completed applications will be accepted by the Business Office during regular business hours (8:00 a.m. to 4:30 p.m.), Monday through Friday.

"Completed applications will be accepted by the Business Office during regular business hours (8:00 a.m."

documented · checked 2026-10-13 · Download the Charity Care Uninsured Financial Assistance Policy

contacts.phone217-532-4204

"To inquire about these programs please contact our Financial Counselor at [217-532-4204](tel:12175324204)."

documented · checked 2026-10-13 · Financial Assistance

contacts.hoursMonday through Friday, from 8 a.m. to 4:30 p.m.

"You can reach the Financial Counselor at **217-532-4204**, Monday through Friday, from 8 a.m. to 4:30 p.m."

documented · checked 2026-10-13 · Patient Billing - Hillsboro Health