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Patient & Visitor Information

Healthcare Financial Assistance

At Northwestern Lake Forest Hospital, we understand that medical expenses are often unplanned. In the event of financial hardship, we help our patients explore available resources to resolve their medical bills—and ensure that all patients receive high-quality care without regard for their individual ability to pay.

To learn about our full range of Financial Assistance Programs, download our brochure in English or Español.

 

Healthcare Financial Assistance Can Help

Full or partial assistance may be available based on your financial condition. The Healthcare Financial Assistance (HFA) and Hospital Uninsured Discount Assistance (HUDA) Application is used to determine eligibility. If approved, this program covers medically necessary services provided by Northwestern Lake Forest Hospital and our Emergency Room Physicians. It does not apply to any other fees you may incur.

 

How to Apply

To be considered for a full or partial discount under our HFA or HUDA policies, you must provide the information and documentation requested in the application. You must also apply for other existing financial resources that may be available to pay for your healthcare, such as Medicare, Medicaid, Kidcare, Family Care, Workers' Compensation and other liability claims.

Please complete the appropriate application:

Return it to the address on the form with all supporting documentation, including:

  • Copy of last year’s tax return, all schedules and W2 forms
  • Copy of last three months’ pay stubs or proof of other income
  • Copy of last three months’ bank statements
  • Copies of all outstanding bills: automobile, medical bills, credit card statements, etc.

 

What Happens Next?

Once the complete application is received, a determination will be made and a written response will be sent to the applicant within 30 working days of receipt. If you have any questions or require additional assistance in completing the application, please call our Customer Service Department at 847.535.6100.

For more information, view our Frequently Asked Questions.

Frequently Asked Questions

What is Healthcare Financial Assistance (HFA)?
Healthcare Financial Assistance is Northwestern Lake Forest Hospital’s program to reduce or eliminate charges for medically necessary healthcare. If you qualify, your bill for hospital services may be reduced or eliminated. However, you will still need to contact the physicians involved in your care to discuss payment arrangements for their charges.

 

How can I qualify for HFA?
You may request an application form at any Registration area, or by contacting Customer Service directly at 847.535.6100. Your eligibility is determined after completing the Healthcare Financial Assistance and Hospital Uninsured Discount Assistance application, applying for any other programs, such as Medicaid, which may help pay for your care, and providing supporting documents such as tax forms and paycheck stubs.

Approval is based on financial need using an income and asset formula that accounts for past, present and expected future resources. Generally, partial bill waivers are available for those earning up to three times the Federal Poverty Guidelines. There are two types of approval:

  • Full = 100% of remaining Northwestern Lake Forest Hospital (NLFH) and our Emergency Room (ER) physician charges are waived.
  • Partial = A portion of NLFH and our ER physician charges are waived, and a payment plan is arranged for the remaining balance.

 

I have insurance, but cannot afford to pay the deductible and/or coinsurance. What can I do?
If you qualify, HFA can be used to waive a portion of the amounts you would normally be responsible for, up to 100% of Northwestern Lake Forest Hospital charges. HFA is always applied after any and all insurance payments or legal settlements.


What is Hospital Uninsured Discount Assistance (HUDA)?
Hospital Uninsured Discount Assistance provides a discount to uninsured Illinois residents at or below 600% of the federal poverty level for medically necessary healthcare. If you qualify, your bill for hospital services may be reduced. However, you will still need to contact the physicians involved in your care to discuss payment arrangements for their charges.

 

How can I qualify for HUDA?
You may request an application form at any Registration area, or by contacting Customer Service directly at 847.535.6100. Your eligibility is determined after completing the Healthcare Financial Assistance and Hospital Uninsured Discount Assistance application, applying for any other programs, such as Medicaid, which may help pay for your care, and providing supporting documents such as tax forms and paycheck stubs.

Approval is based on financial need using an income and asset formula that accounts for past, present and expected future resources. Generally, partial bill waivers are available for those earning up to six times the Federal Poverty Guidelines. If you qualify, a portion of NLFH and ER physician charges are waived, and a payment plan is arranged for the remaining balance.

 

What about fees from doctors and other health professionals for my care?
Although HFA and HUDA cover the cost of medically necessary services performed by Northwestern Lake Forest Hospital, it does not cover the cost of services billed by independent groups, such as private physicians and specialty care groups (other than our ER physicians). You must contact the physicians involved in your care to arrange payment plans or explore other arrangements.

 

If I do not qualify for HFA or HUDA, do I have any other options?
Yes. Northwestern Lake Forest Hospital reviews each case independently and will assist you in establishing a payment plan and/or directing you to other community resources that may be able to help.

 

What if I do not agree with the HFA or HUDA determination?
You have the right to appeal the decision by providing any information you believe supports your qualifications to the Director of Patient Financial Services.

Billing Questions

If you need or have already received services at Northwestern Lake Forest Hospital, and might have difficulty paying your portion of the hospital bill, please contact our Customer Service Representatives at 847.535.6100 during weekdays from 8:30 a.m. to 4:00 p.m., or contact us anytime online.