Financial Assistance
The Sliding Fee Program
The Sliding Fee Program allows us to reduce or “slide” the fees for the care you or your family receive at Siouxland Community Health Center and Siouxland Community Health of Nebraska. Any patient can apply for the Sliding Fee Program to help pay for their care. To make an appointment, or for more information, please call our Financial Counselors at (712) 226-9213.
The following documents are used for income verification:
- Most recent tax return or W-2 (If reflects current income)
- Wages, most current pay stub(s), last full month
- Unemployment benefits
- Workman’s compensation
- Social Security Benefit Statement
- Child Support – Divorce decree
- ADC / FIP Statement
- Rental Income
- Retirement benefits – Pension
HealthCare.gov Certified Application Counselors
Siouxland Community Health Center also staffs five Certified Application Counselors. Our counselors assist patients here at the health center as well as locations around the Siouxland Community.
Certified Application Counselors are available to answer questions regarding the Affordable Care Act and may also assist consumers with the enrollment process. Appointments are preferred, and can be made by calling (712) 226-9213. If you would like more information about the Affordable Care Act, please visit www.healthcare.gov.
Good Faith Estimate
You Have the Right to Receive a “Good Faith Estimate” Explaining How Much Your Medical Care Will Cost
If you are an uninsured and/or a self-pay patient, you have the right to receive a Good Faith Estimate for the total expected cost of any nonemergency services at Siouxland Community Health Center.
Who is uninsured or self-pay? If you pay all of your health care expenses out-of-pocket and you are not enrolled in a health insurance plan that pays for part of your care, you are uninsured or self-pay. This includes patients who do not receive Medicaid, Medicare, or commercial health insurance through an employer or the healthcare.gov marketplace.
How do I get a Good Faith Estimate? The estimate will be given to you in writing at least one business day before your scheduled appointment or service.
For questions or more information about your right to receive a Good Faith Estimate, please visit www.cms.gov.