Plan Your Visit

If you need assistance in paying for any Total Health Care services, you may be eligible for our discount payment program. You will need to bring in documents to establish eligibility for the sliding fee scale.

To establish a sliding fee scale at Total Health Care you will need:

1. Family Size:

• List of names and birthdates for all household members or anyone supported by the household

2. Proof of Income: Bring in all that apply from the following list:

• W-4 and / or a copy of current year’s Income Tax Return
• Copies of two pay stubs for bi-weekly pay or four pay stubs or weekly pay
• Notarized letter from employer stating total amount of the last four paychecks or expected earnings for the next six months
• Unemployment award letter
• Current year pension benefits letter
•  Current year SSA/SSI/DSS award letter
•  Current year AFDC award letter
• PAC denial letter

3.  Proof of NO Income: Bring in ONE of the following: 

• “Verification of No Income” form (available at front desk)
• Letter stating patient has no income signed by both the patient and a valid reference

If you would like to apply for benefits, or check your eligibility for benefits, you will need to bring your brith certificate, your social security card and your state identification.