Ascension Alexian Brothers - Behavioral Health Hospital
Locations

Ascension Alexian Brothers - Behavioral Health Hospital

  • Mental Health
  • Hospital/Medical Center

Hours

Open 24 hours a day, 7 day a week

Ascension Illinois Financial Assistance

As part of our faith-based mission, Ascension Illinois is dedicated to helping the most vulnerable and treating everyone with compassion, dignity and respect. Many people who need assistance don't realize that they qualify. That's why we encourage you to call us or apply for financial assistance if you need help. We're here for you.

Eligibility guidelines

For self-pay patients, financial assistance ranging from 85% to 100% discounts is available based on the latest Federal Poverty Guidelines. For Illinois residents with a family gross income of less than or up to 250% of the Federal Poverty Guidelines, a 100% discount is available on any amounts remaining after insurance payments. The amount of financial assistance will be determined once all third-party payment amounts have been identified.

Complete the financial assistance application even if you are unsure that you qualify. To talk to a customer service agent, call 833-272-7581

How to apply — self-pay and insured patients

  1. Download and complete the application form, letter of support and cover letter.
  2. Gather copies of the supporting documents listed on the application. This may include government ID, pay stubs and tax information.
  3. Mail the application and documentation to the Ascension Illinois address on the form.
  4. If you need help, call 833-272-7581 to talk to a customer service agent or contact the hospital directly.
  5. We will respond, in writing, within a reasonable time period. In the meantime, payment of your bill will be suspended.

Financial assistance applies only to hospital charges and is not available for any doctor or other provider bills you might receive separately. However, some of these providers do participate in the financial assistance program.

Other programs

  • Self-pay discount — For patients who do not qualify for our main financial assistance program, we provide an automatic uninsured self-pay discount. This discount is already reflected in your bill and does not require an application. Not available for those who receive a pre-negotiated discount.
  • Catastrophic discount — Limits your out-of-pocket costs over a 12-month period for medically necessary services when these costs exceed 25% of your family's gross income. This discount will be considered when you apply for financial assistance.
  • Payment plans — Payment arrangements are available for both self-pay and insured patients.
  • Neighborhood Resource — Find free and reduced-cost social services in your area, including food, housing, transportation, financial assistance and more.

You may also be eligible for public programs such as Medicaid or Medicare. Applying for these programs may be required before requesting financial assistance.

Additional forms and policies

Forms and policies are available in several languages:

Amount Generally Billed Calculation

English (Arabic) العربية босански(Bosnian)
简化字 (Chinese Simplified) 漢語 (Chinese Traditional) Hrvatski (Croatian)
(Farsi) فارسی Tagalog (Filipino) Français (French)
Deutsch (German) Eλληνικά (Greek) ગુજરાતી (Gujarati)
Kreyòl (Haitian Creole) हिंदी (Hindi) Italiano (Italian)
日本語 (Japanese) ភាសាខ្មែរ (Khmer) 한국어 (Korean)
Polski (Polish) Русский (Russian) Srpski (Serbian)
Español (Spanish) ภาษาไทย (Thai) (Urdu) اُردُو
Tiếng Việt (Vietnamese)

Financial assistance application

English (Arabic) العربية босански(Bosnian)
简化字 (Chinese Simplified) 漢語 (Chinese Traditional) Hrvatski (Croatian)
(Farsi) فارسی Tagalog (Filipino) Français (French)
Deutsch (German) Eλληνικά (Greek) ગુજરાતી (Gujarati)
Kreyòl (Haitian Creole) हिंदी (Hindi) Italiano (Italian)
日本語 (Japanese) ភាសាខ្មែរ (Khmer) 한국어 (Korean)
Polski (Polish) Русский (Russian) Srpski (Serbian)
Español (Spanish) ภาษาไทย (Thai) (Urdu) اُردُو
Tiếng Việt (Vietnamese)

Financial assistance policy

English (Arabic) العربية босански(Bosnian)
简化字 (Chinese Simplified) 漢語 (Chinese Traditional) Hrvatski (Croatian)
(Farsi) فارسی Tagalog (Filipino) Français (French)
Deutsch (German) Eλληνικά (Greek) ગુજરાતી (Gujarati)
Kreyòl (Haitian Creole) हिंदी (Hindi) Italiano (Italian)
日本語 (Japanese) ភាសាខ្មែរ (Khmer) 한국어 (Korean)
Polski (Polish) Русский (Russian) Srpski (Serbian)
Español (Spanish) ภาษาไทย (Thai) (Urdu) اُردُو
Tiếng Việt (Vietnamese)

Plain language summary of the financial assistance policy

English (Arabic) العربية босански(Bosnian)
简化字 (Chinese Simplified) 漢語 (Chinese Traditional) Hrvatski (Croatian)
(Farsi) فارسی Tagalog (Filipino) Français (French)
Deutsch (German) Eλληνικά (Greek) ગુજરાતી (Gujarati)
Kreyòl (Haitian Creole) हिंदी (Hindi) Italiano (Italian)
日本語 (Japanese) ភាសាខ្មែរ (Khmer) 한국어 (Korean)
Polski (Polish) Русский (Russian) Srpski (Serbian)
Español (Spanish) ภาษาไทย (Thai) (Urdu) اُردُو
Tiếng Việt (Vietnamese)

Physicians covered and no by financial assistance policy

To assist you in determining whether your physician of emergency or medically necessary care is covered by Ascension Illinois’s Financial Assistance Policy, please select the document below.