Financial Assistance at Fayette County Hospital

As a patient of Fayette County Hospital you may be eligible for financial assistance under the terms and conditions this hospital offers to qualified patients. For more information contact our financial counselor at 618-283-5443.

In order to consider your accounts for a possible charity allowance and/or a reduction in your monthly payments, we must have the following information:

• The Request for Financial Statement form completed.  (This form can be printed from this page)
• Copies of your income tax returns for the previous two years.
• Proof of income for the last three months.  (Check stubs must be copied)
• Copies of Checking and Savings accounts balances.
• Proof of disability or a copy of a letter from Division of Family Services verifying/(or denial) state assistance/benefits.
• All proof of the above must be submitted in writing.

The Patient Accounts Department maybe contacted Monday through Friday, 8:00 am to 4:00 pm at 618-283-5443.