Glenns Ferry Health Center • Glenns Ferry, ID
Valley Health Center • Grand View, ID
Desert Sage Health Center • Mountain Home, ID

About Us

Sliding Fee Scale

 

 

Glenns Ferry Health Center, Inc.

2017

Sliding Fee Schedule

 

 

 

 

 

(Does not apply to group physicals, contract procedures, and/or dental procedures)

* CO-PAYMENTS AND NOMINAL FEE DUE AT TIME OF SERVICE *

 

 

75%

Discount

Income Range

50%

Discount

Income Range

25%

Discount

Income Range

Family

Size

Below 100%

Poverty

135%

150%

200%

1

0 – 12,060

12,061 – 16,281

16,282 – 18,090

18,091  - 24,120

2

0 – 16,240

16,241 – 21,924

21,925 – 24,360

24,361 - 32,480

3

0 – 20,420

20,421 – 27,567

27,568 – 30,630

30,631 - 40,840

4

0 – 24,600

24,601 –33,210

33,211 – 36,900

36,901 – 49,200

5

0 – 28,780

28,781 – 38,853

38,854 – 43,170

43,171 – 57,560

6

0 – 32,960

32,961 – 44,496

44,496 – 49,440

49,441 – 65,920

7

0 – 37,140

37,141 – 50,139

50,139 – 55,710

55,711 –74,280

8

0 – 41,320

41,321 – 55,782

55,783 – 61,980

61,981 – 82,640

9

0 – 45,500

45,501 – 61,425

61,426– 68,250

68,251 – 91,000

10

0 – 49,680

49,681 – 67,068

67,069 – 74,520

74,521 – 99,360

11

0 – 53,860

53,861 – 72,711

72,712 – 80,790

80,791 – 107,720

12

0 – 58,040

58,041 – 78,354

78,355 – 87,060

 87,061  - 116,080

13

0 – 62,220

62,221 – 83,997

83,998 – 93,330 

93,331 – 124,440

 

                                   Each additional family member = $4,180                         

                                 100% Discount  =  $20.00  Nominal Fee Per Visit Required

75% Discount  =  25% of net charge

50% Discount  =  50% of net charge

25% Discount  =  75% of net charge

 

Special Services/Rates:

1.      Dental services may or may not qualify for a sliding fee

                                                (Please ask reception for details).

2.      Childhood Immunization free with exception of administration fee.

3.      Alcoholism counseling referrals and linkages available.

4.      Special service for Medicare patients (Assignment accepted-no charge            above deductible and co-insurance).

5.      Special rates for group physicals.

6.      Special services for prenatal/delivery services to low income families.

 

Income levels are based on the 2017 Federal Poverty Guidelines.  As stated in the Federal Register, “Income” refers to “total cash receipts before taxes, from all sources”.

 

1.  Wages               2.  Public Assistance                 3.  Social Security

4.  Alimony             5.  Unemployment                    6.  Dividends or Interest

7.  Child Support    8. Pensions                               9. Farm or Self-Employment

10. Rental Income 11. Workman’s Compensation  12.  Veteran’s Benefits

 

Glenns Ferry Health Center, Inc.

2017

Sliding Fee Schedule

 

 

 

 

 

(No se aplica a grupos de fisicos, o procedimientos de contrato, y/o muchos procedimientos dentales)

 * Co-Pagos y pago nominal es debido al momento del Servicio *

 

Tamano de Familia

75%

Discount

Income Range

50%

Discount

Income Range

25%

Discount

Income Range

Family

Size

Below 100%

Poverty

135%

150%

200%

1

0 – 12,060

12,061 – 16,281

16,282 – 18,090

18,091  - 24,120

2

0 – 16,240

16,241 – 21,924

21,925 – 24,360

24,361 - 32,480

3

0 – 20,420

20,421 – 27,567

27,568 – 30,630

30,631 - 40,840

4

0 – 24,600

24,601 –33,210

33,211 – 36,900

36,901 – 49,200

5

0 – 28,780

28,781 – 38,853

38,854 – 43,170

43,171 – 57,560

6

0 – 32,960

32,961 – 44,496

44,496 – 49,440

49,441 – 65,920

7

0 – 37,140

37,141 – 50,139

50,139 – 55,710

55,711 –74,280

8

0 – 41,320

41,321 – 55,782

55,783 – 61,980

61,981 – 82,640

9

0 – 45,500

45,501 – 61,425

61,426– 68,250

68,251 – 91,000

10

0 – 49,680

49,681 – 67,068

67,069 – 74,520

74,521 – 99,360

11

0 – 53,860

53,861 – 72,711

72,712 – 80,790

80,791 – 107,720

12

0 – 58,040

58,041 – 78,354

78,355 – 87,060

 87,061  - 116,080

13

0 – 62,220

62,221 – 83,997

83,998 – 93,330 

93,331 – 124,440

 

Cada miembro familiar adicional = $4,180

                   100% Descuento  = Costo maximo de $20.00 cada cita

75% Descuento  =  25% del cobro total

50% Descuento  =  50% del cobro total

25% Descuento  =  75% del cobro total

 

Servicios/tarifas especiales:

1.      Cier tos servicios dentales no qualifican para el descuento

         (hable con La recepeionista para mas informacion).

2.      Vacunas de ninõs gratis con la excepción de costo de la administración.

3.      Referencias de consejos de alcoholismo y contactos disponibles.

4.      Servicios especiales para pacientes de Medicare (asignación aceptada-                ninguna carga sobre deducible y co-insurance.

5.      Tarifas especiales para grupos de físicos.

6.      Servicios especiales para prenatal/obstétricos servicios para familias de              bájos ingresos.

 

Niveles de ingresos son basados en pautas de 2017 Federal Poverty Guidelines.  Como en El Registro Federal, “ingresos” refiere al “total’ de dinero antes de taxas.

1.  Sueldo                   2.  Asistencia Pública       3.  Seguro Social

4.  Alimentos              5.  Desempleo                 6.  Dividendos o interés

7.  Pensión                  8.  Ayuda de niños           9. Sueldo de rentas        

10.Granja o empleo de uno mismo       11.  Compensación de trabajadores

12.  Beneficios de veteranos

 

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About Us

Glenns Ferry: (208) 366-7416 • Grand View: (208) 834-2929 • Mountain Home: (208) 587-3988