We are committed to providing the highest quality care, regardless of your ability to pay.
Ryan White Sliding Fee Scale
Patients with active Ryan White coverage are automatically enrolled in the Ryan White Sliding Fee Scale. Patients’ placement on the Ryan White Sliding Fee Scale and their respective nominal fee for services are determined by their household income.
After their Ryan White application is approved, patients are eligible to receive Ryan White Sliding Fee Scale discounts as long as their Ryan White coverage remains active.
Please visit our Ryan White Services page to apply and learn more.
Health Center Sliding Fee Scale
Damien’s Health Center Sliding Fee Scale program offers discounts to eligible patients with a household income at or below 200% of the Federal Poverty Level. Patients’ placement on the Health Center Sliding Fee Scale and their respective nominal fee for services are determined by their household income.
Once approved, patients are eligible to receive Health Center Sliding Fee Scale discounts for one year. Patients must reapply at the end of their one-year eligibility period, or any time there is a change to their household size or income.

Hardship Assistance Program
The Hardship Assistance Program (HAP) is Damien Center’s charity care program, which can offer retroactive discounts on healthcare services for patients who are unable to pay.
The HAP is intended to be used only for charges already incurred. This means you may only apply to the HAP if you have already received a bill from Damien Center and are unable to pay your outstanding charges.
If approved for HAP discounts, patients’ outstanding balances will be discounted by their respectively approved HAP discount amount.
Additionally, patients who are approved for HAP discounts are eligible to receive Damien Pharmacy HAP discounts for a six-month period.
- For approved patients with a household income at or between 0% – 200% of the Federal Poverty Level, pharmacy co-pays are reduced to $0.00.
- For approved patients with a household income at or above 201% of the Federal Poverty Level, pharmacy co-pays are reduced to $10.00.
Frequently Asked Questions

A sliding fee scale is a discount on your healthcare offered if your income and family size meet a certain threshold.

The Health Center Sliding Fee Scale offers discounts to any patient with an FPL of under 200%.
The Ryan White Sliding Fee Scale offers discounts to patients that have active Ryan White enrollment and an FPL under 500%.
For people with active Ryan White enrollment, the Ryan White Program provides additional benefits to ensure that you are not overwhelmed by healthcare costs. We will continue to bill your insurance, but your deductible, co-insurance, and co-pay will be discounted to the nominal fee according to your placement on Ryan White Sliding Fee Scale.

Yes, because if you qualify, you may pay less than your insurance cost-sharing for your services. We will continue to bill your insurance, but your deductible, co-insurance, and co-pay will be discounted down to your approved rate.

The amount you pay will depend on the service you receive and your Federal Poverty Level. Please see the Sliding Fee Scale table to determine your amount due.

- Completed Application (see link above)
- Valid Photo ID
- Proof of Address
- Proof of Household Income

We base eligibility on the Federal Poverty Level (FPL). This percentage is calculated based on two (2) factors:
- Gross Income – this is the amount of money you make each year before taxes. This includes salary, unemployment benefits, disability or social security benefits, investment income, or other sources of income that support your household.
- Family Size – this includes legal children, a civil union partner or married spouse, and legal dependents that are living together.

We will accept the following supporting documentation for proof of income:
- Most recent Federal Tax Return
- 4506T - requests for transcript of tax return, verification of non-filing
- 30 days of pay stubs
- Other income which includes the following: social security, public assistance, retirement pensions, food stamps, child support, alimony, interest income, and other verifiable forms of income

- For the Sliding Fee Scale Discount Program, you must re-apply every year or anytime your financial status changes.
- For the Ryan White Sliding Fee Scale, you must apply every 6 months.
- For the Hardship Assistance Program, you must re-apply every time you receive a bill and cannot pay it.

Patients will receive a decision letter via e-mail with more information, explanation of discount, and instructions for appealing if they did not receive an initial approval while meeting with a Patient Financial Counselor.

Please email us at [email protected] with any questions or visit the front office at any Damien Center service location.