Sliding Fee Discount Program
At Banyan Community Health, we are committed to serving the members of our community in every way we can, regardless of their ability to pay. We welcome all patients regardless of their status, insurance coverage, or financial situation. We are a Federally Qualified Health Center (FQHC), which means that we actively work to ensure that any financial barriers to care are eliminated.
Our Sliding Fee Program was established to ensure that patients can access medical services, regardless of their financial situation. The sliding fee discount is based on ability to pay so that all individuals, including the underinsured or uninsured receive healthcare services. Patients are informed of the Sliding Fee Program through posted signage at our community health facilities, in patient brochures, online and by our Banyan Community Health’s staff.
How does the Sliding Fee Discount Program Work?
Banyan Community Health does not discriminate based on financial situation, immigration status, race, ethnicity, color or national origin, age, disability, gender, marital status, parental status, religion or sexual orientation. Our Sliding Fee Discount Program is based on an individual or family’s ability to pay for care. Sliding fee discounts are based on income and family size, and are determined by the current Federal Poverty Guidelines.
To participate in the Sliding Fee Discount Program, a patient must provide information regarding members of their household (family size) and the income of those household members, along with proof of the last month of income for each member in that household.
How to Apply for the Sliding Fee Discount Program
To apply for the Sliding Fee Discount and determine eligibility, you will need two (2) forms of documentation for each adult in the household.
Acceptable forms of income documentation include:
- Signed Federal Income Tax Return with W-2 forms attached from the last year filed. (Both signatures are required if filed jointly)
- If you do not have a copy, you can request a copy of the return transcript by calling the IRS at 1-800-829-1040 or online at http://bit.ly/IRS_Transcript
OR
If you are not required to file income taxes, please submit two (2) of the following documents as proof of income:
- Three (3) recent months of bank statements showing direct deposit of income
- Annual Social Security Benefit Statement (If you do not have a benefit statement, you can request a copy by calling Social Security at 1-800-772-1213.)
- Employment paystubs for the last four weeks
- Unemployment Statement
- TANF Statement
We Also Offer Pharmacy Discounts
Ask us about our available Pharmacy discounts, too. Save money and have your medications delivered directly to your doorstep, without any additional fees.
Read more about our Pharmacy here.
Contact Banyan Community Health
To learn more about our Sliding Fee Discount Program, please contact us at Banyan Community Health. We will work with you to make sure you and your family get the care you need at a price you can afford.
