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Our Sliding Scale Program.....
- Northern Counties Health Care, Inc., offers reduced fees to
patients who meet income guidelines as set forth each year by
the Federal Government.
- Eligibility is based on both income and family size. The program
is offered to make health care more affordable for those who need
assistance.
- To enroll you will need to:
- provide proof of residency (Vermont Drivers License, Voter
Registration Card, or Vermont State Income Tax Return);
- complete an application form with documentation of yearly
income (generally your most recent Federal Tax Return).
- Depending on which sliding scale level you qualify for, your
fees will be reduced to a lower specific percentage of charges
or to a fixed charge per service.
- You must enroll or re-enroll in the program each year.
- Members of our health center staff can answer your questions
and help you with the application process.
To participate in the sliding scale fee reduction program you must
live in one of our service area towns in Vermont listed below:
| Albany |
Averill |
Avery's Gore |
Barnet |
Barton |
Beecher Falls |
| Bloomfield |
Brownington |
Brunswick |
Burke |
Cabot |
Canaan |
| Charleston |
Concord |
Craftsbury |
Danville |
East |
Ferdinand |
| Gilman |
Glover |
Granby |
Greensboro |
Groton |
Guildhall |
| Hardwick |
Holland |
Island Pond |
Kirby |
Lewis |
Lemington |
| Lunenburg |
Lyndonville |
Maidstone |
Morgan |
Newark |
Norton |
| Passumpsic |
Peacham |
Ryegate |
Sheffield |
St. Johnsbury |
Stannard |
| Sutton |
Victory |
Walden |
Warren's Gore |
Warner's Grant |
Waterford |
| Westmore |
Wheelock |
Wolcott |
Woodbury |
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NORTHERN COUNTIES HEALTH CARE,
INC. (NCHC)
Sliding Scale Discount Schedule 2007
| |
A |
B |
C |
D |
|
Family
Size
|
Patient
Pays |
Patient
Pays |
Patient
Pays |
Patient
Pays |
Patient
Pays |
| Medical |
$10.00 |
25% |
50% |
75% |
100% |
| Dental-tier1 |
$15.00/15% |
25% |
50% |
75% |
100% |
| Dental-tier2 |
40% |
60% |
60% |
80% |
100% |
| 1 |
<= $9,800 |
$9,801 – 12,250 |
$12,251 - $17,150 |
$17,151 - $19,599 |
>$19,600 |
| 2 |
<= $13,200 |
$13,201 – 16,500 |
$16,501 - $23,100 |
$23,101 - $26,399 |
>$26,400 |
| 3 |
<=$16,600 |
$16,601 - $20,750 |
$20,751 - $29,050 |
$29,051 – $33,199 |
>$33,200 |
| 4 |
<=$20,000 |
$20,001 - $25,000 |
$25,001- $35,000 |
$35,001 - $39,999 |
>$40,000 |
| 5 |
<=$23,400 |
$23,401 - $29,250 |
$29,501 - $40,950 |
$40,951 - $46,799 |
>$46,800 |
| 6 |
<=$26,800 |
$26,801 – $33,500 |
$33,501 – $46,900 |
$46,901 – $53,599 |
>$53,600 |
| 7 |
<=$30,200 |
$30,201 - $37,750 |
$37,751 – $52,850 |
$52,851 - $60,399 |
>$60,400 |
| 8 |
<=$33,600 |
$33,601 - $42,000 |
$42,001– $58,800 |
$58,801 – $67,199 |
>$67,200 |
| 9 |
<=$37,000 |
$37,001 – $46,250 |
$46,251 - $64,750 |
$64,751 - $73,999 |
>$74,000 |
| 10 |
<=$40,400 |
$40,401 - $50,500 |
$50,501 - $70,700 |
$70,701 - $80,799 |
>$80,800 |
In accordance with Federal law and regulations, this agency does not
discriminate in admission or access or treatment or employment in
its programs or activities. For further information, contact the Executive
Director, 748-9405.
NCHC receives grant support for its operations from the U.S. Department
of Health and Human Services in an amount that equals about 10% of
its total corporate budget.
| ©
Northern Counties Health Care Inc. - PO Box 388 - 165 Sherman
Dr. - St. Johnsbury, VT 05819 |
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