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Financial Assistance

Adjustable Payment Plan

The Adjustable Payment Plan (APP) is available to any patient utilizing our family of clinics. Patients that are uninsured, underinsured, and/or have been denied health insurance and whose income is at or below the 200% of the current Federal Poverty Guidelines may qualify for this program. Eligibility for this plan is based on gross family income (all working members within the household) and household size (all members in the family). All qualified applicants will have their patient responsibility payments adjusted based on these two factors:

What is household income?

Income includes any of the following for each member of the household: earnings, unemployment compensation, workers’ compensation, Social
Security, Supplemental Security Income, public
assistance, veterans’ payment, survivor benefits, pension or retirement income, interest, dividends, rents, royalties, income from estates, trusts,
educational assistance, alimony, child support,
assistance from outside the household, and other miscellaneous sources. Noncash benefits (such as food stamps and housing subsidies) do not count.

What is family size?

Family is defined as: a group of two people or more (one of whom is the householder) related by birth, marriage, or adoption and residing together; all such people (including related subfamily members) are considered as members of one family.

A Family is further defined as anyone receiving more than
50% of their support from a head of household, whether
living within the same household or not. Students must produce income proof from family members providing
more than 50% of their support, and grants for attending school.

Will I qualify for the Adjustable Payment Plan?

You can now use our quick online calculator to see if you will qualify for the Adjustable Payment Plan. Certain individuals may qualify at different levels.

Adjustable Payment Plan Calculator

Complete the following questions and submit to find out it you may qualify for our Adjustable Payment Plan.

Using the Adjustable Payment Plan

The Adjustable Payment Plan will reduce your patient financial responsibility if you qualify for the program. For example, the service you receive during an appointment could be valued at $500 but your patient responsibility may be minimized. For care that is valued at $500, you could potentially pay $35, $50, etc. (patient payment will vary depending on family size and income).

All Patients that have no insurance or are underinsured are encouraged to apply. Patients may qualify if their household income is at or below 200% of the Federal Government’s Poverty Guidelines.

You can apply during regular business hours at any of our health centers.  See our health center locations.

Once you apply, our staff will let you know if you qualify for this Program and the adjustment in payments you will receive to your care.  Your adjustment is based on two factors:

(1) the number of people in your household

(2) your household gross income.

Households that are living at or below 200% of the Federal Poverty Guidelines will fall into one of the categories below (A-E). Each category has a different nominal fee or minimal fee per visit. Pharmacy and Dental Services have different fees. After establishing eligibility, our registration specialist will review your financial responsibility in full. *Please note that your level of adjustment will be based on the Federal Poverty Guidelines as published every year by the U.S Department of Health and Human Services and that your total patient responsibility may be greater than your minimal fee.

The Federal Poverty Guidelines are issued each year in the Federal Register by the Department of Health and Human Services (HHS). They are used to determine financial eligibility for many federal programs. 

Please bring proof of:

(1) Your Gross Household Income: current 2 pay stubs, SSI, Recent Taxes, etc. for every member of your household.

(2)  Your Photo ID

If you are having issues with demonstrating proof, please call your local health center and ask to talk to a Registration Specialist.  

All services within CNAHSI’s approved scope of project for which CNAHSI charges patients is offered on the APP.

Please call your local health center and ask to speak to a Registration Specialist.  We are happy to help clarify any questions that you may have.

Still have questions? Call our Admission’s Specialist at 256-533-6311 ext. 2525

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