Insurance Information
Patient Rights and Responsibilities | Insurance Information
Sliding Fee Discount | Medicine Assisance Program | Forms
We accept health insurance coverage including Medicaid, Medicare, HAWK-i, and private insurance; however, we may be out-of-network, please ask.
Medicaid - You do not pay the $3.00 co-pay for your appointment at the CHCFD. We accept Title 19, Medicaid, and Medipass.
Medicare - We accept standard Medicare assignments. If you qualify for a sliding fee discount, we will apply discount to the charges not covered by Medicare payments.
Private Insurance - We will file your health care claim according to the specific provisions of your Policy.
Sliding Fee Discount
- Patients without insurance or with high deductibles or Co-Pay may qualify for a discount based on household size and income. You must apply for the discount.
- When calling for your first appointment schedule a financial aid appointment.
- Bring your current tax return and the last 30 days of pay stubs for entire household to your financial aid appointment for sliding fee evaluation and discount determination, or ask about other options for verification, if none of these are available.
- Sliding fee scales need to be reapplied for on a yearly basis or if household size/income changes.
- Be prepared to pay the required Minimum Fee and additional sliding fee charges at your visit.
- If you have insurance, please bring your ID card to all appointments and inform staff of any changes in coverage.
 Medical Service Fees
Sliding Fee Discount Minimum Fee = $15 per visit
Additional fees, depending on where the patient fits on the Sliding Fee Discount scale may apply. For example, if the patient receives a 90% discount on services rendered and the total charge for the services received is $200, there will be an additional $5 fee due.
Please ask your CHCFD Health Care Staff for clarification.
Labratory Service Fees
All uninsured patients have the option to utilize our outsourced lab at a discounted rate which must be paid at the time of service. Fees for labs are dependent on the type of labs ordered by the provider and will be disclosed at the time of service.
Please ask your CHCFD Health Care Staff for clarification.
Medicine Assistance Program (MAP)
Administration Fee = $6 per prescription
This fee is charged for service provided by CHCFD personnel. It is not for the cost of the drug.
Many drugs have an alternative generic version which is available in the Community Health Center Pharmacy. Most generic drugs produce the same results as the expensive brand medication and they will cost less over time. Also, many pharmaceutical companies place a limit on the number of months they will provide the drug.
Please ask your CHCFD Health Care Provider if there is an acceptable generic drug that will work as well as the brand drug. In most instances, the medication can be provided at time of visit and most times for a reduced fee.
Forms
Please print the necessary forms and
bring the completed forms with you
to your appointment.
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