Penobscot Community Health Care (PCHC) is dedicated to ensuring everyone in our community has access to high-quality healthcare, regardless of their financial situation. We understand that navigating healthcare costs can be challenging, and that’s why we offer the Pchc Affordable Care Program, also known as our Sliding Fee Program. This program is designed to reduce the financial burden of healthcare, making it accessible when you need it most.
What is the PCHC Affordable Care Program (Sliding Fee Program)?
The PCHC Affordable Care Program, or Sliding Fee Program, is a financial assistance program that offers discounted healthcare services based on your income and household size. It’s not health insurance, but rather a discount program available to eligible individuals and families to help manage healthcare costs at PCHC facilities. As a Federally Qualified Health Center (FQHC), PCHC is committed to providing care to all, and this program is a cornerstone of that commitment.
Who Can Benefit from the Affordable Care Program?
If you are uninsured, underinsured, or find it difficult to afford healthcare costs, the PCHC Affordable Care Program might be able to help. Even if you have existing health insurance, you may still qualify for reduced fees through this program. Eligibility is determined by your household income and family size, using federal poverty guidelines as a benchmark.
How Much Can You Save with the Sliding Fee Program?
The amount you save depends on your income level and household size. The program operates on a sliding scale, meaning those with lower incomes and larger families may receive greater discounts. Visit fees (co-pays) can range from as low as $10 to $55 per visit. Significant discounts may also be available for dental services. Applying for the program is free, and our Outreach and Enrollment Specialists can assist you in understanding your potential savings.
Refer to the fee schedule below for a detailed breakdown of potential discounts based on income level and household size.
What Healthcare Services are Covered?
The PCHC Affordable Care Program covers a wide range of healthcare services provided directly by PCHC. This includes visits to:
- Primary care providers (family medicine, pediatrics, geriatrics)
- Mental health counselors
- Physical therapists
- Chiropractors
- Specialty care providers
- Preventive dental care
It’s important to note that the program does not cover services received at hospitals or from other healthcare providers outside of the PCHC network. For assistance with hospital bills, our Outreach and Enrollment team can provide guidance on separate hospital financial assistance programs.
How to Apply for the PCHC Affordable Care Program
Applying for the Affordable Care Program is straightforward. You can download the application online HERE, pick up an application at any PCHC location, or call to have one mailed to you.
To complete your application, you will need to:
- Provide information for all household members.
- Submit proof of income for all income sources for everyone in the household. The application packet includes a worksheet detailing acceptable forms of income verification.
- Ensure all adult household members complete their own individual applications.
Once your completed application and supporting documents are received, PCHC staff will review your application and contact you if any further information is needed. The effective date of your enrollment in the program is your patient signature date on the application.
Understanding the Difference: Affordable Care Program vs. Health Insurance
It’s crucial to understand that the PCHC Affordable Care Program is not health insurance. It’s a financial assistance program to reduce your out-of-pocket healthcare costs at PCHC. However, our Outreach and Enrollment team can also assist you in exploring health insurance options, including MaineCare and the Health Insurance Marketplace. They can help you navigate the complexities of health insurance and find coverage that meets your needs.
Prescription Assistance and Procedure Pricing Transparency
In addition to the Sliding Fee Program, PCHC offers a Prescription Assistance Program (RxAP) to help patients access affordable medications. Our RxAP team works to find low-cost or no-cost medication options, ensuring you have access to the prescriptions you need.
Furthermore, PCHC is committed to price transparency. We provide a price list for our most frequently provided procedures, allowing you to understand the full cash price for services. Remember that the Sliding Fee Program can significantly reduce these costs for eligible individuals. No one will be denied care due to inability to pay.
Contact Our Outreach and Enrollment Specialists Today
Navigating affordable healthcare can feel overwhelming, but you don’t have to do it alone. PCHC’s dedicated Outreach and Enrollment Specialists are here to help. They can answer your questions about the Affordable Care Program, assist with the application process, explore health insurance options, and connect you with prescription assistance programs.
Contact an Outreach and Enrollment Specialist today by dialing 207-992-9200 and selecting the extension for your nearest PCHC location:
- Brewer Medical Center: ext. 1466
- Capehart Community Health Center: ext. 1115
- Community Care and Geriatrics Department: 2005
- Dental Center: ext. 2005
- Helen Hunt Health Center: ext. 3078
- Hope House: ext. 2005
- Jackman Community Health Center: ext. 3078
- Medical Specialists: ext. 2005
- Penobscot Community Health Center: ext. 1115
- Penobscot Pediatrics: ext. 2005
- Seaport Community Health Center: ext. 2005
Let PCHC help you access the quality healthcare you deserve through the Affordable Care Program.
PCHC Sliding Fee Program – Fee Schedule
Levels based on Income Level and Household Size
| Services | Level 1 | Level 2 | Level 3 | Level 4 | Level 5 | >200%of FPG |
|---|---|---|---|---|---|---|
| Primary CareIncluding PCHC Specialty, PCHC Lab testing & X-ray | $10 | $25 | $35 | $45 | $55 | Full Fee |
| Preventative Dental Care | $35 | $45 | $55 | $65 | $75 | Full Fee |
| Restorative/Other Dental | $35 | 35% Discount | 25% Discount | 15% Discount | 5% Discount | Full Fee |
| Infusion Services | $35 | 40% Discount | 35% Discount | 30% Discount | 25% Discount | Full Fee |
| PharmacyEffective Feb 1. 2019 | 40% Discount | 35% Discount | 30% Discount | 25% Discount | 20% Discount | Full Fee |
