Edinburgh/Trafalgar Family Health Centers, Inc

Eligibility charts

Eligibility – Sliding Fee Scale

If you or any members of your family are uninsured, you may qualify for reduced-cost health services through our Sliding Fee Scale. To see if you are eligible for discounted services, please use the annual income guidelines below:

2006 FEDERAL POVERTY GUIDELINES & SLIDING FEE SCALE

		LEVEL A (< 100%)	LEVEL B (125%)		LEVEL C (150%)		LEVEL D (175%)		LEVEL E (200%)
Family Size *	Income Presented	Less than	Minimum	Maximum	Minimum	Maximum	Minimum	Maximum	Minimum

1	Annual	$10,210	$10,211	$15,314	$15,315	$17,867	$17,867.50	$20,419	$20,420

2	Annual	$13,690	$13,691	$20,534	$20,535	$23,957	$23,957.50	$27,379	$27,380

3	Annual	$17,170	$17,171	$25,754	$25,755	$30,047	$30,047.50	$34,339	$34,340

4	Annual	$20,650	$20,651	$30,974	$30,975	$36,137	$36,137.50	$41,299	$41,300

5	Annual	$24,130	$24,131	$36,194	$36,195	$42,227	$42,227.50	$48,259	$48,260

6	Annual	$27,610	$27,611	$41,414	$41,415	$48,317	$48,317.50	$55,219	$55,220

Sliding Fee Discount		minimum	75%		50%		25%		0%
Patient Pays		$15.00	25%		50%		75%		100.0%
Updated 8/1/07

Questions? Want to apply for Sliding Fee Scale

The eligibility guidelines may not be correct for all situations. To find out what programs you qualify for and/or to apply, please contact a Benefit Advocate by e-mail at contactus@etfhc.org or by phone at (317) 987-8032. A Benefit Advocate will respond within 24-48 hours.