Quality Care for All
We take steps to ensure you are able to afford the quality care you deserve.
If you do not have insurance, or you’re underinsured (your insurance doesn’t cover everything you need it to), DCHC offers a Sliding Fee Discount Program, which provides reduced rates for those who qualify. Visit fees will be based on a sliding scale using income and household size. To apply for the Sliding Fee Discount Program, please download the applications below. You can bring the application and your Proof of Income to your visit and our team will help determine if you qualify.
Sliding Fee Scale Application
To apply for the Sliding Fee Scale Program, complete one of the following applications below.
Patient Assistance Services
- Sliding Fee Scale
DCHC offers discounts based on income in accordance with federal poverty guidelines and household size. You can qualify even if you are insured. Please note that the Sliding Scale Fee is not insurance, and qualifying for Sliding Scale Fee at DCHC only covers services accessed at DCHC.
- Prescription Assistance
If you have concerns about paying for your prescriptions, we have a Prescription Assistance Program that may be able to help. Please talk to your providers about your concerns, and they will connect you with the program.
- Medicaid Applications
As a Certified Medicaid Application site, we can assist you with completing Medicaid applications for you and/or your children. These services are offered at no-charge to you.
- Medicare Assistance
For our patients with Medicare, we can assist you in enrolling or re-enrolling annual in your Medicare Part D plan. We will be glad to assist you with any other questions you may have regarding your Medicare policy.
- Health Insurance Marketplace
We have Certified Application Counselors on site who can provide you with assistance in completing applications, renewals, exemptions/appeals, or any other questions you may have regarding insurance.
Meet Courtney
Courtney Ogden, Certified Application Counselor, assists patients in finding affordable health coverage options- whether it be through Medicaid, Medicare, or the Health Insurance Marketplace. Call today at 318-878-6162 to schedule your free consultation.
How to Apply for the Sliding Fee Scale Program
Please bring the Sliding Fee Scale application and one of the following Proof of Income documents to your visit at DCHC. This documentation is a required part of the application process and demonstrates proof of income for all of your income sources. You will be charged full rate for visits until documentation is provided.
Accepted documents for Proof of Income:
- Prior year W-2
- Two recent pay stubs
- Letter from employer or Form 4506-T (if W-2 is not filed)
- Self-employed: Three months of income and expenses for the business
- If you do not have any written proof of income, you can submit a self-declaration of income letter.
For any questions or help applying to the Patient Assistance Program, contact us at 318-878-6168 and we will be happy to assist you.