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Some of our medical services are free, while many other services, not including dental, are eligible for reduced rates on a set sliding fee scale.  A sliding fee scale is a system of charging you for services based on your ability to pay.  To qualify for the sliding fee scale, we require proof of:

• identification (see Acceptable Proof of Identification below)
• Indian River County residency (see Acceptable Proof of Indian River County Residency below)
• household income (see Acceptable Proof of Household Income below)

If you choose to have your eligibility determined, our staff will provide assistance with the eligibility determination process, including verification of the information you provide.  If you choose not to have your eligibility determined (waived eligibility), you will be responsible for paying the full fee for any medical service you receive that has a fee associated.

Eligibility for Existing Patients
If you are an existing patient already receiving reduced medical fee rates, as of March 15, 2010, when you are due to be re-determined, you will need to make an appointment with our eligibility staff in our new Eligibility Office (772-794-7406) and bring in proof of eligibility as listed below, .  Eligibility will be re-determined every 6 months, although you should contact us anytime your information changes to be re-determined.  If you don't provide the necessary information before your re-determination date expires, you will be responsible for paying 100% of any medical fees charged, including any amount insurance does not cover.

Eligibility for New Patients
If you are a new patient seeking reduced medical fee rates, as of March 15, 2010, you will need to make an appointment with our eligibility staff in our new Eligibility Office (772-794-7406) and bring in proof of eligibility, as listed below, to see if you meet the requirements.  If you meet the requirements, you will need to be re-determined every 6 months, although you should contact us anytime your information changes to be re-determined.  If you don't meet the requirements, you will be set at 100% and required to pay the full fee for medical services, including any amount insurance does not cover.  If your status changes, you can contact our Eligibility Office to update your eligibility and see if you qualify for reduced rates. 

Eligibility for Dental Services
Our dental services are limited to those who are 200% or less of the Federal Poverty Level (FPL) according to income verification.  Proof of identification, residency and income requirements as noted below apply.
 

• Any official local, state or federal government or military issued ID with photo, for example:
       - Driver's license
       - Government ID
       - Valid passport (US or non-US)
• Valid work ID
• Valid school ID

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• Any official valid local, state, federal government or military issued document
• A bill within the last 60 days with your name and address listed from any of the following:
  - electric bill
  - water bill
  - gas bill
  - cable bill
  - satellite bill
  - medical bill (not from the health department)
  - pest control bill
  - home phone bill
  - cellular phone bill
• Credit card or insurance statement within last 60 days
• Recent pay stub within last 60 days
• Voter registration card
• Housing/mortgage agreement
• Rental agreement/lease (with landlord's name/address/phone #)
• Previous month's rental receipt (with landlord's name/address/phone #)
• Prior year property tax receipt or current year's property tax bill
• W-2 form for previous year
• Unemployment document within last 60 days
• Vehicle registration for current year
• County school record/registration certificate showing current enrollment in school
• For incarcerated individuals, residency will be established by residency immediately prior to incarceration
• Homeless individuals must bring in one of the following:
  - homeless declaration signed by agency personnel
  - law enforcement booking sheet
  - declaration letter from family or friend
  - letter of support (contact Eligibility Office for further information)

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• Another family, other than yours, that lives in the same house you live in
• Any single adult over 18 living with relatives is considered to be a separate family, unless the adult is a member of a separate economic unit

Wages and Salary:

• Pay stubs
• Letter from employer(s) on company letterhead signed and dated by your employer (with their name/address/phone #) showing gross earnings
• 1040 ES quarterly tax form (dated within 90 days from eligibility determination)
• 1040 form or W-2 form for the past year
• Gross income from self-employment
• Most recent income tax return

Unearned Monthly Income:

• Social security and disability benefits
• Public assistance or welfare payments
• Unemployment compensation
• Spousal support (alimony) received
• Worker's compensation for lost income
• Court ordered child support received or paid

Other Unearned Income (figured monthly):

• Veterans and military allotments
• Retirement and pension benefits
• Insurance, annuity, estate or trust income
• Private loans that recur
• Dividends or interest on savings, stocks/bonds
• New rental income and royalties
• Contributions
• Savings, investments, trust accounts and other resources readily available to the household
• Letter of Financial Support (contact Eligibility Office for further information)

Expenses (figured monthly):

• court ordered child support
• child or day care expenses

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Some fees for medical services may depend on specific individual situations or may not be eligible for the sliding fee scale.  These services include:

Services with Fee Exceptions:

• Family planning/birth control/contraceptives (fee varies)
• Childhood immunizations (vaccinations) through age 18 (free through Vaccines for Children program)
• Travel immunizations (full fee for service)
• Adult immunizations, if here only for this service (full free for service)
• School/work physicals (fee varies)
• Sexually transmitted disease (STD) testing, treatment and counseling (fee varies)
• Tuberculosis/communicable disease control (fee varies)

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