Memorial Home Services recognizes that there are occasions when a patient will not be able to pay a medical bill. Obtaining care at Memorial Home Services is not dependent on one's ability to pay; however, Memorial Home Services expects the patient to provide complete documentation in order to be considered for charity or "free" care.
The patient or responsible party must provide the following information in order for Memorial Home Services to determine the appropriate amount of charity care to be applied to the patient's account:
- Financial Assistance Application
- Proof of income for last three months
- Copy of latest federal income tax return
- Proof of denial for Medicaid benefits from Illinois Healthcare and Family Services
- Copy of checking/savings account statements for past three months
Consideration for Financial Assistance is based on the patient's and/or guarantor's financial status in comparison with the Community Services Administration Poverty Income Guidelines.
After the application has been reviewed and a determination has been made, the patients will be notified in writing.
For more information about financial assistance of to request an application, call 217-788-4663 or 800-582-8667, or email us.