Wheaton Franciscan Healthcare is committed to providing exceptional and compassionate care to all people we serve, regardless of their financial status. To help meet this commitment, the Community Care program provides assistance to those in need in a fair and non-discriminatory manner.
If you believe that you may have difficulty paying for your medical care at Wheaton Franciscan Healthcare, please contact one of our Financial Advocates. They may be reached at 800-728-0159. Our Financial Advocates can help you set up payment plans and apply for financial assistance, including our Community Care program. Our Community Care program provides financial assistance with Wheaton Franciscan Healthcare medical bills, both the hospitals and Covenant Clinic providers, based on income and family size. The complete application is available by following one of the links below.
We also offer a discount to patients with no health insurance, or where there are exclusions on the health insurance policy. The discount applies to all hospital and Covenant Clinic services except cosmetic procedures, or in cases where a package price is arranged in advance, such as Bariatric procedures.
Please click on the appropriate form to print off the application for financial assistance.
Community Care Financial Assistance Form - English
Community Care Financial Assistance Form - Spanish
Community Care Financial Assistance Form - Bosnian
Payment for Services - Covenant Clinic
Payment for Services Covenant Clinic
Payment for Services Covenant Clinic - Bosnian
Payment for Services - Hospital
Payment for Services Hospital
Payment for Services Hospital - Bosnian
Payment for Services Hospital - Spanish