Sliding Fee Program

• If you are paid weekly, bring 4 paycheck stubs.
• If you are paid bi-weekly, bring 2 paycheck stubs.
• If you are paid twice a month (1st/15th or 15th/30th), bring 2 paycheck stubs.
• If you receive monthly Social Security and/or disability payments, bring a proof of income letter or Benefit Verification letter stating the monthly amount you are paid.

Your visit could cost as little as $15, depending on your income and the number of people in your family.

Here’s an example of how the Sliding Scale Program works:

• A family of 4 with a monthly income of less than $2,208 pays a flat fee of $15 per visit.
• A family of 4 with a monthly income of $2,208–$2,759 receives a 75% discount.
• A family of 4 with a monthly income of $2,760–$3,312 receives a 50% discount.
• A family of 4 with a monthly income of $3,313–$4,417 receives a 25% discount.

You’ll need to pay for services and any amounts that are unpaid on your account on the day of your visit.

No — even uninsured patients are responsible for a portion of their care costs. Everyone is expected to pay their portion on the day of their visit.

The Sliding Fee Program is made possible by federal grants through the Bureau of Primary Health Care.

No, you do not.

You will receive a statement if you do not pay your share of the bill on the day of your visit.

Paying on the day of your visit gives you continued access to Cherry Health services. Unpaid charges may be referred to a collections agency for further action, so it is important to pay on time. Our staff can work with you to arrange a payment plan, if needed.

Many patients use our Sliding Fee Program to help with costs. If you have not applied for the program, call our Billing Department at 616-965-8282 to get started.

If Cherry Health participates in your insurance plan, your contributions toward our Sliding Fee Program may be applied to your annual deductible and coinsurance. However, you will still be responsible for any copays your insurance requires. Call 616-965-8282 to discuss your situation with a billing coordinator.

Some special services offered through Cherry Health, such as dentures, eyeglasses, and birth control, have lower set fees for uninsured patients who qualify. Be sure to discuss the fees for those services before your appointment. Call our Billing Department at 616-965-8282 for details.

Our Billing Department is here to help. They may ask you questions like, “Where do you live?” and, “How do you pay for food?” to get a sense of your situation.

Yes, all information that we collect about you is confidential.

You can qualify for discounted services before meeting your spend down. However, only your discounted fees will go toward meeting your spend down.

Under the law, health care providers need to give patients who don’t have certain types of health care coverage or who are not using certain types of health care coverage an estimate of their bill for health care items and services before those items or services are provided.

• You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling such items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• If you schedule a health care item or service at least 3 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule a health care item or service at least 10 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after scheduling. You can also ask any health care provider or facility for a Good Faith Estimate before you schedule an item or service. If you do, make sure the health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after you ask.
• If you receive a bill that is at least $400 more for any provider or facility than your Good Faith Estimate from that provider or facility, you can dispute the bill.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.