Sliding Fee Introduction

FourPoints Health Sliding Fee Discount policy is designed to provide discounted care to those who have no means, or limited means, to pay for their medical, dental, mental health and/or vision services.

FourPoints Health will determine program eligibility on a person’s ability to pay and will not discriminate on the basis of age, gender, race, sexual orientation, creed, religion, or national origin. The Federal Poverty Guidelines are used in developing and updating the Sliding Fee Schedule (SFS) to determine eligibility.

FEDERAL POVERTY GUIDELINES

Applicants are required to provide income verification. If you do not have income, and are supported by someone else, please have that person fill out the Supported Income Statement (link below) and provide that as income eligibility.

SUPPORTED INCOME STATEMENT

Once you have completed your review of the guidelines, and you are able to provide the necessary income verification, please click the link below to enter the portal. Accepted forms of income verification should be one of the following: last 2 paycheck stubs for each household adult, signed statement from employer on letterhead, unemployment benefits letter, Social Security benefits letter, last (current) income tax return, or supported income statement (above)