Financial Assistance is Available
Thorek Memorial Hospital (TMH) is committed to meeting the needs of everyone in the communities it serves, including those who cannot pay for their care. Therefore, TMH provides financial assistance to all patients who qualify under its Financial Assistance Policy (FAP). This is a summary of the policy.
To determine if a patient is eligible for financial assistance, his/her annual income is compared to the current Federal Poverty Guidelines (FPG). Generally:
- Patients with household income less than or equal to 200% of FPG receive free care.
- Patients with household income over 200% but not greater than 600% of FPG receive discounted care. The discount is based on the Medicare allowable amount, or a percentage of the cost of care, as detailed in the full policy.
- No patient eligible for financial assistance will be charged more than the Medicare allowable amount for eligible care.
If a patient is eligible for a government-funded program, or has sufficient insurance coverage or assets available to pay for the care, he/she may not be eligible for financial assistance.
Financial assistance is available for emergency or other medically necessary services provided by TMH. Elective services are not covered.
Financial Assistance Policy
You can download free copies of Thorek's Financial Assistance Policy, a Plain Language Summary, Billing and Collections Policy, and a list of covered providers below. Free copies can also be obtained in our Patient Financial Services Department or by mail.
Download our Financial Assistance Policy:
Download our Plain Language Summary of the Financial Assistance Policy:
Download our Billing and Collections Policy:
Download a list of the providers who are covered and not covered under the Financial Assistance Policy (updated quarterly):
How to Apply
Patients may apply for financial assistance by completing the application form and submitting it, along with any supporting documents, to Thorek using the contact information listed below. Financial counselors are available to assist patients in completing the application.
Download our Financial Assistance Application Form:
For more information, questions about the application process or to check the status of an application submitted, please call (773) 975-6843.
Applicants may mail or fax the completed application and supporting documents to Thorek’s address listed below or bring them to the hospital.
Thorek Memorial Hospital
Patient Financial Services
850 W. Irving Park Road
Chicago, IL 60613
Phone: (773) 975-6843
Fax: (773) 975-3220