hospital staff and patient

Patients & Visitors

Financial Assistance

Illinois Valley Community Hospital affirms and maintains its commitment to serve our community in a manner consistent with our mission, vision and values. These emphasize our commitment to meet the health care needs of our community through the provision of high-quality patient care. Within the limits of our resources, the use of our facility's services and efforts will be provided to aid all persons, regardless of their financial resources.

In order to qualify for assistance, you must:

  • Complete an application form (we'll help if necessary).
  • Provide documentation of income for the last 12 months, including federal tax form 1040 and the last two pay stubs for all household members.
  • Provide evidence that you have pursued all other payment sources, including public aid.
  • Provide bank statements for the last two months for all household members.

Our financial assistance application must be completed and signed by you. We use income guidelines established by the U.S. Dept. of Health and Human Services to determine if you are eligible for charity care. We do verify assets regarding your eligibility, so please provide all the information promptly so we can try to help you as quickly as possible.

Contact Us

If you have any questions about IVCH Financial Aid or any other offers of assistance, please call our Billing Department or the Patient Financial Services Supervisor at 815.780.3418.

Print the desired form, complete it, and then bring or mail it with appropriate documentation to:


Attention: Patient Financial Services

925 West St.

Peru, IL 61354

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