Medical document

Sliding Fee Discount Program

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Patient Focused

There are many people in our community that do not have health insurance, and there are many in our community who have health insurance, but are still struggling with their portion of health care costs.

We are dedicated to providing a comprehensive set of primary medical and dental care services for patients.

Sliding Fee Program

The sliding fee program allows us to reduce or “slide” the fees for the care of you or your family at CHC/SEIA. You may apply for the program during an appointment to see if you qualify for a discount. Eligibility is based on:

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Family Income

 

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Family Size

 

If your family size or income changes, you may re-verify at any time throughout the year.

In order for an application to be reviewed, persons applying must provide documentation:

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Check stub

 

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W2 or W9

 

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Social Security Benefits

 

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Retirement benefits

 

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Disability benefits

 

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Unemployment

 

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Workers Compensation benefits

 

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Veterans benefits (FIP;etc.)

 

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Alimony/Widowers benefit

 

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Student loans

 

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Military family allotments

 

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Most recent tax return

 

How can I Apply

Once you become a patient at CHC/SEIA, a Patient Service Representative will be available to meet with you at your visit to help you enroll in the Sliding Fee Program.

What can I bring for proof of income?

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At least one consecutive MONTH of most recent paycheck stubs

 

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Current personal income tax return

 

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Unemployment benefit statement

 

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Social Security (SSI) or Disability Income Statement

 

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Other documentation of Income

 

How much do I owe?

The amount of discount depends on your family size and income. We encourage patients to make regular payments at the time of your visit.

Can I apply for the Sliding Fee Program if I have insurance?

Yes, you can still apply for a discount. The discount will then be applied after any insurance payments. This includes private insurance and Medicare.

Our Partners

This health center receives HHS funding and has federal Public Health Service deemed status with respect to certain health or health-related claims, including medical malpractice itself and its covered individuals.  For more information, please visit https://bphc.hrsa.gov/ftca.

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