Many medicines and health care procedures are very expensive. Several governments require that hospitals provide low-cost or free medical services to those who could otherwise not afford the services. However, those who can afford the services need to pay. Federally Qualified Health Centers (FQHCs) must provide health services to individuals even if they cannot pay for these services.
Depending on the individual’s ability to pay, the medical costs will vary. Some individuals will receive discounts, while wealthier individuals might have to pay for the full costs of the treatments. Hospitals ascertain the individual’s ability to pay based on their household income and based on the number of dependents. The guidelines for the fee scale come from the federal poverty guidelines. Every year, the sliding fee scale changes, so hospitals must be ready to change their billing accordingly. All patients who are 200% below the federal poverty line must receive all possible discounts. Patients below the poverty line must receive free medical services, but they sometimes have to pay small fees around $10. Sometimes, patients who suffer from a specific kind of disease receive a pay cap where the patient does not have to pay for any costs beyond a certain point.
If patients refuse to give information about their income and their family size, they can be ineligible for discounts and might have to pay the full costs of the medical services. Usually, hospitals provide a grace period where patients can still receive medical services before they provide documentation, since some patients can have sudden medical problems and cannot get a hold of documentation in time. Usually, patients have two weeks. Initially, patients receive discounts based on their self-reporting. Proof of Income
The patient must provide a proof of income if employed, such as a 1040, a W2, a pay stub or a written statement from an employer. If not employed, the patient must provide one of several pieces of documentation such as a social security check stub, public assistance check, letter from the department of Medical Assistance or Social Services, a completed zero income form, a statement from a parent or friend or a letter from a 501 organization. They must also have proof of their address. Once a year, patients must be re-certified for discounts, since patients can have income levels that rise and fall depending on their line of work.
The sliding fee scale is mostly for those who do not have insurance. However, those who do have insurance, but have a very high deductible, might be eligible for discounts.