At G.A. Carmichael Family Health Center, we understand that everyone’s financial situation is different. We firmly believe that everyone should be able to access high-quality, comprehensive healthcare for themselves and their loved ones, regardless of their insurance coverage or ability to pay. For that reason, we are proud to offer a wide range of financial services to support our patients in need.
G.A. Carmichael Family Health Center provides access to health services to all men, women, and children regardless of their ability to pay. This is accomplished by adoption of a Sliding Fee Discount Schedule, which offers a range of discounts against charges for services we provide. Ability to pay is determined by a patient’s annual income and family size according to the most recent U.S. Department of Health & Human Services Federal Poverty Guidelines.
Sliding Fee Discount Schedule patients receive a discount of charges based on where they fall on a discount schedule based on the annual Federal Poverty Guidelines. Depending on household size and household income, patients are assigned a discount tier of the fees normally charged for a medical or dental visit, with a nominal fee of $40 for medical services and $50for dental services for the 100% tier and below.
Your eligibility for our Sliding Fee Discount Schedule will be determined by your income and the size of your household. To qualify for the sliding fee discount Applicants must provide one of the following: prior year W-2, prior year 1099, Social security income benefit determination letter, SSI Check, bank statements, deposit history, Cash Receipts book, prior year tax return, social security papers, most recent pay stub, unemployment check, bank statements, deposit history, unemployment determination letter, public assistance determination letter, letter from employer, or Form 4506-T (if W-2 not filed). Self-employed individuals will be required to submit detail of the most recent three months of income and expenses for the business. Adequate information must be made available to determine eligibility for the program. Self-declaration of Income may only be used in special circumstances and will take precedent as proof of income. Specific examples include participants who are homeless. Patients who are unable to provide written verification must provide a signed statement of income, and why (s)he is unable to provide independent verification.
If you have questions about beginning the Self Declaration process or your eligibility for our Sliding Fee Discount Schedule, we encourage you to give us a call at (601) 859-5213 today. One of our compassionate team members will be happy to answer any questions you may have.
Downloadable Excel Spreadsheet:
Additional Financial Relief Programs
G.A. Carmichael is dedicated to providing affordable and accessible healthcare to those who are underinsured and underserved. For this reason, we are proud to offer additional financial programs to support our patients. These programs include the following:
Financial Aid for Healthcare in Central Mississippi
If you live in Canton, Belzoni, Yazoo, Madison, or Humphreys County and are in need of financial relief for your healthcare services, look no further than G.A. Carmichael Family Health Center. We offer a wide range of financial aid services for men, women, and children who need primary healthcare and dental care services.
If you have any questions about our financial aid programs, we encourage you to call us today at (601) 859-5213. To make an appointment with one of our expert providers, please use our convenient online appointment request form.