NorthShore University HealthSystem’s financial assistance policy offers free care to qualifying patients whose income is at or below 200 percent of the Federal poverty level. Patients whose income is above 200 percent of the Federal poverty level or are underinsured may qualify for discounts based on our financial assistance or self pay discount policies.

A team of financial counselors at each of our hospitals and many medical office sites, along with our customer service representatives, are ready to assist patients with limited financial resources or limited health coverage. 

  1. Contact a financial counselor or business office representative by calling the phone number on your statement.  They will be able to advise you on potential eligibility and send you a financial disclosure document or you can print the document yourself (see link below). 
  2. Complete the financial disclosure.  To complete this document you will need employment, income, expense and asset information. This information must be provided with supporting material, such as pay check stubs and sources of income, bank account statements and income tax forms. This will be explained in the instructions accompanying the form.
    • Please mail the completed application and supporting documentation to the address listed below. Or please fax it to 847.982.6957.

      NorthShore University HealthSystem
      Patient Financial Services
      P.O. Box 1006
      Suite 330
      Skokie, IL 60076-9877
  3. Once the completed disclosure and documentation are received, they will be reviewed and a determination will be made, based on your family size and the information provided.   You will be notified if you qualify for a reduction of your bill and/or an extended payment plan.