Sliding Fee Scale


Frequently Asked Questions


What is the Sliding Fee Discount Program?

The Sliding Fee Discount Program is a Federal program that allows Sixteenth Street Community Health Centers to discount our normal charges for health care services rendered at our locations. The Sliding Fee Discount Program is available to all patients regardless of immigration status.  Sixteenth Street community Health centers will never deny healthcare based on the patients inability to pay.

 

Who can apply for the Sliding Fee Discount Program?
Anyone is welcome to apply for the Sliding Fee Discount Program. All patients without insurance MUST be evaluated for the Sliding Fee Discount Program. Failure to do so will result in an inability to receive a discount under the Sliding Fee Scale.  If you refuse to be assessed and/or provide income documentation and family size information you will not be eligible for the sliding fee.

Approval for the program is based on family size and combined household income in accordance with the Federal Poverty Guidelines- http://aspe.hhs.gov/poverty
If you are eligible for other assistance programs, such as Medicaid, we will assist you in applying for these programs in addition to the Sliding Fee Discount Program.

 

How is eligibility for the Sliding Fee Discount Program determined?
Eligibility is determined solely on the family size and combined income for the household. You must show proof of income, from the last 30 days, for all family members living in your household.  If you do not provide adequate proof of income or you do not qualify based on your income and family size you will be responsible for the full charges related to your services.

 

How do I apply for the Sliding Fee Discount Program?
You must meet with a Financial Counselor to apply for the Sliding Fee Discount Program. You can schedule an appointment at any of our front desks or you can call (414)672-1353 option 3 and schedule an appointment.

 

Are appointments required or can I just walk in?
Appointments are encouraged to reduce waiting times to speak with the Financial Counselor. If you would like you may walk in and speak to a Financial Counselor at any of our locations, Monday – Friday between the hours of 8am – 5pm.

You can schedule an appointment by contacting Business Services at (414)672-1353 option 3.

 

What type of documents do I need to bring to apply for Sliding Fee Program?
You will need to bring in proof of income (last 30 days) for all family members living in the household. You will also need to fill out the “SSCHC-Patient Information Form”.

 

What can be used as Proof of Income?
The following documents are acceptable to bring for evaluation of the sliding fee. This is required for all members of a household (not including roommates/non-family members) and will be used for purposes of determining any applicable discounts under the sliding fee.

  • Prior year income tax return or W-2
  • Check stubs from the 4 weekly or 2 biweekly pay periods preceding the application
  • Un-employment check(s)
  • Social Security (SSI) checks or statements
  • Pension checks
  • Alimony, child support, etc.
  • Attestation of income by employer
  • Bank statements to verify any direct deposits

 

Who is considered “family” in regards to determining the number of dependents for the Sliding Fee Discount Program?
Family size is defined as Mother, Father, Children, Significant Other, Husband, Wife and any dependent adult or child who is supported by the family unit and benefits from the combined household income. Roommates do not qualify as ‘Family’.  Unborn children are not included in the calculation of family size.

  • Children up to 18 years old, living at home, qualify as a dependent and their income will not count toward the families’ income
  • Children 18-21 years old, who are in college and still live at home, will qualify as a dependent their income will not count toward the families’ income
  • Children over 18 years old, not in school and are working, will be considered on their own income and will not count as a dependent
  • Elderly parents living with their grown children, who do not have any type of Social Security, pension, or income count as a dependent.

 

Is my lab work covered under the Sliding Fee Discount Program?
All patients who are approved for the Sliding Fee Discount Program at the time of the lab service will have their labs covered at no cost to the patient.

 

Are my medications covered under the Sliding Fee Discount Program?
Patients without any third party insurance who have been approved for the Sliding Fee Discount Program may be able to receive a subsidy for prescription drugs through SSCHC’s 340B drug pricing program. This program is only available at the agency’s contracted pharmacies. If you are approved for the Sliding Fee Discount Program and are eligible for a prescription drug subsidy, you will be given a list of contracted pharmacies that accept our discount.

Any patient with third party insurance, whether a drug benefit exists or not, are not eligible for this program.

 

When is my SFS effective?
The sliding fee is active the same day as you are approved.

 

When does my Sliding Fee Discount expire?
The sliding fee is active for 1 year from the approval date.

You must re-apply prior to expiration date in order to continue being covered under the Sliding Fee Discount Program. Failure to do so may result in the patient being responsible for the full amount of any charges incurred during the lapse.

 

What services does the Sliding Fee Discount Program cover?
The sliding fee scale applies only to those services provided directly by or controlled by SSCHC. Services provided under referral are not covered by the SSCHC sliding fee. Some examples are: Medical visits, Behavioral Health visits, AODA services, and Physical and Occupational Therapy.

 

I do not want to provide my financial information. Am I still eligible for the Sliding Fee Discount Program?
Eligibility for the Sliding Fee Discount program is based on your income and family size. If you choose not to provide Sixteenth Street Community Health Centers with this information you will be responsible for the total charges for services rendered.

 

How often do I need to apply for the Sliding Fee Discount Program?
You must apply every year. You may re-apply sooner than 1 year if there is a change in your current household size or income.

 

How much will I pay if I am approved for the Sliding Fee Discount Program?
The charge for your visit depends on your income, family size, and the type of service you received. When you are approved for the Sliding Fee Discount Program you will receive a card as well as a handout that details your financial responsibility for services rendered. Payments are due at the time of service.

I cannot pay my bill from the clinic. What should I do?
Contact Business Services as soon as possible, (414)672-1353 option 3, and speak with a Financial Counselor. They will help you explore other options to assist you in paying your balance. Sixteenth Street Community Health Centers will never deny healthcare due to a patient’s inability to pay for the services.

I have a question regarding the sliding fee program or my bill from the clinic. Who should I contact?
Patients are encouraged to call (414)672-1353 option 3 to be connected to our Business Services Department who can assist with those questions. If you wish to come in person you may do so at the following locations:

Sixteenth Street Community Health Centers – Chavez
1032 S Cesar Chavez Dr.
Milwaukee WI 53204

Sixteenth Street Community Health Centers -20th Street
2906 S 20th Street
Milwaukee, WI 53215

Sixteenth Street Community Health Centers – Waukesha
309 E North Street
Waukesha, WI 53188