Sliding Fee

Horizon Health Care Clinic Doctor Answering Patient Phone Call

Horizon Health Care Sliding Fee Program

Horizon Health Care ensures that no one will be denied access to medical or dental health services due to inability to pay.

The Sliding Fee Program allows us to reduce the cost or “slide” the fees for the care you or your family receives at any Horizon Health Care location. You are encouraged to apply for the program whether or not you have insurance.

 

Reduced Costs for Patient Care

Our Sliding Fee Program offers reduced prices on office visits and services provided in the Horizon clinic to all individuals and families who qualify. If you apply and qualify at one Horizon location, you receive the discount at all of our medical and dental clinic locations.

The Sliding Fee Program is based on family income and may reduce your medical bill 20%, 40%, 60%, 80% or more. You may qualify with or without insurance, and you may qualify even though you have Medicare or Medicaid.

To apply for the Sliding Fee Program, please submit one acceptable proof of income for all members of your household (related and unrelated) listed below.

Acceptable Proofs of Income:

  • Two most recent pay stubs
  • Current Tax Return
  • Current W-2s from all employment
  • Bank statements supporting income declaration on sliding fee application
  • Social Security or Unemployment Award Letter
  • Department of Social Services Benefit Statements
  • Letter from a government office explaining the benefits you do or do not qualify for (unemployment office or social security office, etc.)
  • Denial letter for an application of benefits (must be dated within the last 3 months)

Anyone claiming to have no income but lacks a documented explanation will be required to self attest, reapply and submit a completed sliding fee application each visit.

Sliding Fee Program Application

Along with proof of income, please also provide a completed Sliding Fee Program application.

Sliding Fee Program Applications are available at any of our locations or apply online. (Please note: this link will take you to a secure, off-site website to enter your information.) All information will remain confidential and will only be viewed by Horizon Health Care.

You can also print the Sliding Fee application here, and return it to your local Horizon clinic’s front desk. All information we receive from you is strictly confidential and can be processed immediately by our office staff. If you have questions, please ask any of our staff.

Sliding Fee Program Eligibility

Eligibility is determined solely on the household size and combined income for the household. If you qualify for the program, the amount you owe for your visit will be reduced according to the discount schedule.

To see if you are eligible, find your family size on the table below. If your family’s annual income is less than the amount listed, you qualify for the Sliding Fee Program at Horizon Health Care.

Family Size Family Income
1 $24,981
2 $33,821
3 $42,661
4 $51,501
5 $60,341
6 $69,181
7 $78,021

 

Sliding Fee Program FAQ

Can I apply for the Sliding Fee Program after a clinic visit?

Yes. If you bring in two current and consecutive pay stubs with your application, the slide will be retroactively applied for 90 days prior to the date of application. If using tax statements, it will be applied to the beginning of the year. This will grant you a slide discount for any prior visits in that time frame.

Is Horizon Health Care a “free clinic”?

No. Even uninsured patients are responsible for the cost of their care.

Who pays for the services that are discounted?

The Sliding Fee Program is made possible by a federal grant through the Bureau of Primary Health Care.

Do I have to be a citizen to apply for the Sliding Fee Program?

No, you do not. All are welcome!

What if I get a statement in the mail?

All patients who do not pay their share of the bill will receive a statement. We do accept payment plans. Amounts outstanding on your account may be referred to a collection agency for further action, so it is important to keep your account up to date.

I have to pay a lot of money before my insurance pays for my health care; can I apply for the Sliding Fee Program?

The Sliding Fee Program can be used in conjunction with your annual insurance deductibles/co-insurance (but not copays that your insurance requires). Call 605- 539-9836 to discuss your situation with a billing representative.

Is my income information confidential?

Yes, all information that we collect about you is confidential.

Who is considered a “household member” in regards to determining the number of dependents for the Sliding Fee Discount Program?

Household size is defined as mother, father, children, significant other, husband, wife and any dependent adult or child who is supported by the household unit and benefits from the combined household income. Roommates do not qualify as ‘household members’. Unborn children are not included in the calculation of household 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 and their income will not count toward the household 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 can be counted as a dependent. If they have income it must be included in the household income otherwise they will be required to apply for the sliding fee program on their own.

When is my Sliding Fee Scale effective?

The sliding fee is active the same day it was submitted and effective until April 30th. Please allow up to 30 days from the time of submitting your application for processing and official approval. The slide can be retroactively applied to earlier visits if the patient applies using pay stubs or tax statements.

I am a Horizon medical and dental patient. Do I need to fill out two different forms?

No, but it would be extremely helpful if you would mention to the front desk that you are also a patient for either dental or medical care after you have submitted an application. We do make every effort to ensure that the approved application is loaded into your files in both the medical and dental electronic health record systems, but this will help us to ensure there are no hassles in the future.

Are any services or labs not covered under the Sliding Fee Discount Program?

All services provided at any Horizon Health Care, Inc. location are available on a sliding fee scale. There are certain services that may have a different nominal fee due to the high cost of outside lab services. Please ask the front desk prior to receiving services for additional information on these.