Paying For Your Visit

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Paying For Your Visit

We accept the following forms of payment:

  • Most private insurances
  • Affordable Care Act Health Plans (Marketplace Insurance)
  • Iowa Medicaid
  • Nebraska Medicaid
  • South Dakota Medicaid
  • Medicare
  • Sliding Fee

We also accept cash, check, and most major credit cards.

financial assistance

Sliding Fee Program

The Sliding Fee Program may allow 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.  If you have insurance, you may still qualify.  To make an appointment, or for more information, please call our Financial Counselors at (712) 226-9213.

No one will be denied access to services due to inability to pay.  There is a discounted/sliding fee schedule available based on family size and income.

The following documents are used for income verification:

(all documents may not apply to all patients)

  1. Most recent tax return or W-2 (if reflects current income)
  2. Wages, most current pay stub(s), last full month
  3. Unemployment benefits
  4. Workman’s compensation
  5. Social Security Benefit Statement
  6. Child Support – Divorce decree
  7. Aid to Dependent Children (ADC) or Family Investment Program (FIP) Statement
  8. Rental Income
  9. Retirement benefits – Pension

HealthCare.gov Certified Application Counselors

Siouxland Community Health Center has six Certified Application Counselors to help patients apply for our financial slide, enroll in a Marketplace insurance plan (healthcare.gov), or apply for Medicare or Medicaid.

Certified Application Counselors are available to answer questions regarding Health Insurance Marketplace plans 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.

Center for Medicare & Medicaid Services

Please visit www.cms.gov for more information on Medicare and Medicaid.

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