Billing
Sliding Scale Discounts
One Community Health offers a Sliding Scale discount based on your household income. This means you pay what you can afford. The amount depends on your income and family size, so if you earn less, you pay less for care.
Who is Eligible and How Much Would You Pay?
All our patients can apply even if you are insured. You can apply at the clinic or online on our website. The application needs to be turned in within 30 days of your last appointment to discount past appointments. This program is based on household income and family size.
How do I read the Sliding Scale chart below?
- Find your family size in the first column.
- Find your yearly income in the column next to your family size.
- See which level (A–D or Full Charge) matches your information.
Federal Poverty Guidelines Effective February 1, 2025:
| Family Size | Level A 0% – 100% Annual Income | Level B 101% – 133% Annual Income | Level C 134% – 166% Annual Income | Level D 167% – 200% Annual Income | Full Charge >200% Annual Income |
|---|---|---|---|---|---|
| 1 | $0 to $15,060 | $15,061 to $20,815 | $20,816 to $25,979 | $25,980 to $31,300 | $31,301 or greater |
| 2 | $0 to $21,150 | $21,151 to $28,130 | $28,131 to $35,109 | $35,110 to $42,300 | $42,301 or greater |
| 3 | $0 to $26,650 | $26,651 to $33,445 | $33,446 to $44,239 | $44,240 to $53,300 | $53,301 or greater |
| 4 | $0 to $32,150 | $32,151 to $42,760 | $42,761 to $53,369 | $53,370 to $64,300 | $64,301 or greater |
| 5 | $0 to $37,650 | $37,651 to $50,075 | $50,076 to $62,499 | $62,500 to $75,300 | $75,301 or greater |
| 6 | $0 to $43,160 | $43,161 to $57,403 | $57,404 to $71,646 | $71,647 to $86,320 | $86,321 or greater |
| 7 | $0 to $48,650 | $48,651 to $64,705 | $64,706 to $80,759 | $80,760 to $97,300 | $97,301 or greater |
| 8 | $0 to $54,150 | $54,151 to $72,020 | $72,021 to $89,889 | $89,890 to $108,300 | $108,301 or greater |
What You Pay by Service Area and Discount Level:
| Service Area | Level A | Level B | Level C | Level D |
|---|---|---|---|---|
| Medical and Dental | $25 | $28 | $30 | $35 |
| Behavioral Health | $0 | $10 | $12 | $15 |
Completing Your Sliding Scale Discount Application
Our Sliding Fee Discount Application is easy if you have the right information and documents with you! For faster processing, please apply online. Let’s walk through how to apply.
Step 1: Gather the following information before applying.
Proof of Income:
In order to apply, you need proof of income for every adult you are claiming as part of the household. You can bring this into the clinic or upload a photo or scan of the documents as part of our secure online application.
Examples of proof of income include:
- Last year’s taxes
- Pension funds
- VA Benefits
- Disability
- Self-employment records
- Wages and Salary
- Unemployment
- Social Security/SSI
- Worker’s Compensation
- Public assistance
For any questions about income verification or the status of your application please contact our billing department at 541-386-6380 and follow the prompts on the phone tree.
Living Situation and Proof of Address for everyone over 18 in the household:
Please provide a Proof of Address from a current utility bill, paystub or valid identification for members who are above 18 in the household that are supported by your income. If you are experiencing houselessness, you can select the specific living situation that relates to you within the Sliding Scale Discount Form below.
Step 2: Apply for the Sliding Scale Discount
The Sliding Scale Discount form will require details about the patient who is applying including Proof of Address from household members over 18 years old.
I’ve Applied, What Now?
Once you have completed your Sliding Scale Discount application and gathered the required information (income verification and proof of address for everyone over 18 in the household), you should receive a letter in the mail within 3 weeks notifying you that your application was Approved, Denied or if there is a Request for Additional Information.
If proof of income is not provided or additional information needs to be provided, please fill out the following Sliding Scale Discount Attestation Applicant Form. Please complete all sections that apply.
Frequently Asked Questions
Other assistance types or estimate questions?
The person responsible for paying the account balance should sign. All other household members will be listed under that primary account holder.
We need proof of income and address for everyone in your household who is 18 or older. This includes adult children, grandparents, aunts, and others living with you.
Please notify our Front Desk staff if someone needs to be removed from your account. We will need that person’s current address so we can create a separate account for them.
No, unless they are part of your household and you share finances for tax purposes.
Yes. If you share finances with family members in your household, their income counts. Eligibility is based on household income. If you have special circumstances, please call us at 541-386-6380, extension 11593.
You can use a utility bill or any other bill that shows your name and address. You cannot use a LabCorp bill or a One Community Health bill as proof of address.
Please call our Billing Department at 541-386-6380, extension 11593, to discuss your options.
If you do not have income (such as wages, Social Security, or unemployment), you can complete an attestation (a form declaring your circumstance) form to explain your situation. Click Here to complete all sections that apply.
You can apply using a one-time application by checking the “Homeless” box on the form.
Please call the Billing Department at 541-386-6380, extension 11593, to update your information. If you do not report changes, your discount may end.
Your discount lasts for one year from the date it starts. You must reapply before or after that date to keep your discount.
Have more questions? Call us at 541-386-6380 ex.11598 and we will be happy to assist you.