About the Sliding Fee Scale
As a Federally Qualified Health Center, PHC offers Medical, Dental, Behavioral Health, Pharmacy and lab services on a Sliding Fee Scale. This means that you may be eligible for discounts depending on your household income and family size.
- Sliding fee discounts are available to you even if you have health insurance.
- Sliding Fee Scale Applications must be renewed annually.
Online Sliding Fee Scale Application
To submit a Sliding Fee Scale Application online, please follow two important steps:
1. Fill out the online application here
2. Click here to submit Proof of Income. **IMPORTANT: Please see the section below for approved Proof of Income documentation.
How Does It Work?
When you check in for your appointment we may ask you for a nominal fee. Any balance remaining after insurance payments and the sliding fee scale discount will be billed to you.
Click here to view our 2024 household size & income guidelines for the sliding fee scale. Patients experiencing houselessness or those with Medicaid may have a slide set for their benefit. You will need to submit recent copies of one of the following documents for each earner in your family:
Most Recent 1040 Tax Form (PHC’s preferred documentation)
One Month’s Recent, Back-to-Back Pay Stubs or Unemployment Checks (for all employment if working multiple jobs)
Social Security or Disability Benefit Letter (or most recent bank statement showing monthly deposits)
Recent bank Statement (for fixed incomes)
Pension or Retirement Award Letter
Grant Award Letter (students only)
Screenshot of WIC Benefits (from the WIC Shopper app)
Please be aware that we cannot accept W-2’s, 1099s, old taxes, or student loan information.
Questions?
Call us a call at (406) 258-4450.
