Low income Patients without Health Insurance or Medicaid/Medicare can qualify for our Sliding Fees.  Check the table below to figure out your fees based on Family Size and Income.

 

Sliding Fee Information

Greater Sioux Community Health Center

 

Effective 3-1-2011

Sliding Fee Scale - Based on 2011 Poverty Guidelines

 

 

 

 

 

 

 

 

Pt. Pays

Pay 0% of Chgs

Pay 25% of chgs

Pay 50% of chgs

Pay 75% of chgs

Pay 100% of chgs

 

 

 

 

 

 

SF Scale

100% SLIDE

75% SLIDE

50% SLIDE

25% SLIDE

0% SLIDE

 

 

 

 

 

 

FPL

< 100% FPL

101% - 133% FPL

134% - 166% FPL

167% - 199% FPL

> 200% FPL

 

 

 

 

 

 

MONTLY INCOME

 

 

 

 

 

 

 

 

 

 

 

# in Household

 

 

 

 

 

1

0-907

908 - 1210

1211 - 1514

1515 - 1814

> 1,815

2

0-1225

1226 - 1634

1635 - 2043

2044 - 2451

> 2,452

3

0-1543

1544 - 2058

2057 - 2571

2572 - 3087

> 3,088

4

0-1862

1863 - 2483

2484 - 3104

3105 - 3724

> 3,725

5

0-2180

2181 - 2907

2908 - 3634

3635 - 4361

> 4,362

6

0-2498

2499 - 3331

3332 - 4164

4165 - 4997

> 4,998

7

0-2817

2818 - 3756

3757 - 4695

4696 - 5634

> 5,635

8

0-3135

3136 - 4180

4181 - 5225

5226 - 6271

> 6,272

9

0-3453

3454 - 4604

4605 - 5755

5756 - 6908

> 6909

10

0-3771

3772 - 5028

5029 - 6285

6286 - 7545

> 7546

11

0-4089

4090 - 5452

5453 - 6815

6816 - 8182

> 8183

12

0-4407

4408 - 5876

5877 - 7345

7346 - 8819

> 8820

 

 

 

 

 

 

YEARLY INCOME

 

 

 

 

 

 

 

 

 

 

 

# in Household

 

 

 

 

 

1

0-10,889

10,890 - 14,519

14,520 - 18,149

18,150 - 21,779

21,780

2

0-14,709

14,710 - 19,613

19,614 - 24,517

24,518 - 29,419

29,420

3

0-18,529

18,530 - 24,706

24,707 - 30,883

30,884 - 37,059

37,060

4

0-22,349

22,350 - 29,799

29,800 - 37,249

37,250 - 44,699

44,700

5

0-26,169

26,170 - 34,893

34 894 -43,617

43,618 - 52,339

52,340

6

0-29,989

29,990 - 39,986

39,987 - 49,983

49,984 - 59,979

59,980

7

0-33,809

33,810 - 45,079

45,080 - 56,349

56,350 - 67,619

67,620

8

0-37,629

37,630 - 50,172

50,173 - 62,715

62,716 - 75,259

75,260

9

0-41,449

41,450 - 55,265

55,266 - 69,081

69,082 - 82,899

82,900

10

0-45,269

45,270 - 60,358

60,359 - 75,447

75,448 - 90,539

90,540

11

0-49,089

49,090 - 65,451

65,452 - 81,813

81,814 - 98,179

98,180

12

0-52,909

52,910 - 70,544

70,545 - 88,179

88,180 - 105,819

105,820