# Sarah D Culbertson Memorial Hospital

Hospital in Rushville, IL. From the state program, Hospital Uninsured Patient Discount Act (210 ILCS 89), rural and Critical Access Hospitals.

Sarah D Culbertson Memorial Hospital likely gives free care to households with a yearly income up to $19,950 for 1 person, $27,050 for 2, $34,150 for 3, $41,250 for 4, $48,350 for 5 or $55,450 for 6. It likely gives a discount to households with a yearly income up to $47,880 for 1 person, $64,920 for 2, $81,960 for 3, $99,000 for 4, $116,040 for 5 or $133,080 for 6.

The hospital makes the final decision.

| Household size | Free care if yearly income is up to | Discount if yearly income is up to |
|---|---|---|
| 1 | $19,950 | $47,880 |
| 2 | $27,050 | $64,920 |
| 3 | $34,150 | $81,960 |
| 4 | $41,250 | $99,000 |
| 5 | $48,350 | $116,040 |
| 6 | $55,450 | $133,080 |

Dollar amounts use the 2026 federal poverty guidelines.

## How to apply

- Call (217) 322-4321 and ask for financial assistance.
- We do not have the deadline yet. Apply as soon as you get a bill, and ask the billing office to pause collections while you apply.

## If you have insurance

If you have insurance, ask whether this policy helps with deductibles and copays.
Keep your insurance. Financial assistance covers bills from this one place only.

## State program in Illinois

### Hospital Uninsured Patient Discount Act (210 ILCS 89), rural and Critical Access Hospitals (the numbers above come from this program)

Illinois law sets lower levels for Critical Access Hospitals and hospitals outside metro areas. If you are an uninsured Illinois resident and your family income is at or below 125% of the federal poverty level, you may qualify for a free bill for care over $300 per visit or stay. If your income is at or below 300%, you may qualify for a discount. The bill is cut to about 135% of what the care cost the hospital. For people who get the discount, the most a hospital can collect in 12 months is 20% of family income. This state law covers uninsured patients only. If you have insurance, the hospital's own policy may still help. Many hospitals offer more than the law requires, so check the hospital's own policy too. You must apply. The hospital decides.

Income levels in the program are free up to 125%, discount up to 300% of poverty level.

Applies to Illinois Critical Access Hospitals and licensed hospitals outside a metropolitan statistical area; uninsured Illinois residents only.

How to apply. Ask the hospital's financial counseling or billing office for its financial assistance application. Apply within 90 days of discharge, the date of service, the hospital's screening, or a denial of Medicaid or other public coverage. The hospital may ask for proof of income (a tax return, W-2, two recent pay stubs, or an employer letter) and proof that you live in Illinois. If you have a problem, call the Illinois Attorney General's Health Care Hotline at 1-877-305-5145.

> A rural hospital or Critical Access Hospital shall provide a charitable discount of 100% of its charges

Source https://ftp.ilga.gov/ILCS/Ch%200210/Act%200089/021000890K10.html, checked 2026-11-11

## Sources

- Hospital Uninsured Patient Discount Act (210 ILCS 89), rural and Critical Access Hospitals https://ftp.ilga.gov/ILCS/Ch%200210/Act%200089/021000890K10.html
  > A rural hospital or Critical Access Hospital shall provide a charitable discount of 100% of its charges

Last checked 2026-11-11.

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