Financial Assistance

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.

The federal government sets limits on what you will have to pay toward your total healthcare costs each year when you visit health networks that accept Ryan White grant funding. These annual limits supersede your cost-sharing agreement with your insurance company. Once you reach your annual maximum, we will continue to bill your insurance, but your patient responsibility will be discounted to $0 for eligible services until January 1st of the following year.

Eligible services that we can count toward your annual maximum include medical appointments, labs, nurse visits, behavioral health visits, co-pays, hospital visits, and prescriptions. If you have healthcare bills from outside health networks, other agencies, or pharmacies, you can submit them to count toward your annual maximum. We are not able to pay those healthcare bills, but your healthcare services with us will be discounted.

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 FPL. 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

Yes, you must re-apply every 12 months or anytime your financial status changes.

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.