Sliding Scale Procedure

Howard Brown Health offers discounted services to patients that are uninsured and meet certain income qualifications. If you qualify, you will pay a sliding scale fee depending on your gross yearly household income (how much money your household makes each year before taxes are taken out).

Sliding Fee Scales

The sliding scale fee is paid at each visit and covers the cost of all exams, vaccinations, and other procedures received during that visit.

* Annual income is represented here as a percentage (%) of the Federal Poverty Line (FPL). The FPL is determined each year by the federal government and varies depending on the size of your household.

^ The Ryan White Program Sliding Fee Scale is for patients living with HIV/AIDS. For these patients, the appropriate fee is collected at each visit until they have cumulatively paid a certain percentage of their income per year in healthcare expenses. This is similar to an “out-of-pocket max” in insurance plans. For more information, read the full “Ryan White Program Sliding Fee Scale” section below.

If you qualify for the Sliding Fee Scale, you should not receive a bill from Quest Diagnostics for your bloodwork and/or other labs received at Howard Brown Health. If you are a qualifying Sliding Fee Scale patient and receive a Quest Diagnostics bill, please email billingteam@howardbrown.org with an image/copy of the bill that you received so that we can help correct the error.

How Do I Qualify?

In order to qualify for discounted services at Howard Brown Health, you must:

• Be a current patient of Howard Brown
• Complete the sliding scale fee application
• Submit your completed application and valid proof of income to Howard Brown Health
  • Email: billingteam@howardbrown.org
  • Fax: 773.388.1602
  • Postal Mail: Howard Brown Health, Attn. Billing Department, 4025 N. Sheridan Rd. Chicago, IL 60613
  • If you are not able to submit these materials via email, fax, or postal mail, please bring them to your next in-person appointment.

Once your documents have been reviewed, you will be informed of the sliding scale fee you qualify for, based on your income level. If you have questions about the sliding fee scale procedure, please call the main line at 773.388.1600 and ask to be transferred to the billing team.

Ryan White Program Sliding Fee Scale

The Ryan White Program is a federal grant program that helps Howard Brown Health cover some health care costs for patients living with HIV/AIDS. To qualify for the Ryan White Program Sliding Fee Scale, you must have proof of your HIV/AIDS diagnosis on file at Howard Brown Health and be uninsured.

The Ryan White Program Sliding Fee Scale is almost identical to the Howard Brown Health Sliding Fee Scale, with two exceptions:

1. Patients at or below 100% of FPL are not charged for any service they receive at Howard Brown.
2. Patients receive charge limits for healthcare expenses, after which they are charged $0 for services received at Howard Brown.

Charge Limits for Patients with HIV/AIDS

To help manage the cost of healthcare for people living with HIV/AIDS, the federal government sets a limit on how much they can be charged for medical expenses per year at organizations that receive Ryan White Program funding. After the charge limit is met in a given year, qualifying patients will pay $0 for services received at Howard Brown Health for the remainder of the calendar year. This is similar to an “out-of-pocket max” in insurance plans. This charge limit is determined by the patient’s income (shown in the Sliding Fee Scales table) and is represented as a percentage (%) of their annual gross income.

Healthcare bills from outside of Howard Brown can also count towards your Ryan White Charge Limit for the year. Examples include bills for prescriptions, medical appointments, mental health services, and hospital visits. Howard Brown will not pay those bills, but they will count them towards your charge limit. In order to count these bills, you will need to provide Howard Brown with a copy of each relevant bill.

Dental Procedures

The following dental services are covered by the Sliding Fee Scale:

• X-Rays
• Comprehensive Oral Exams
• Deep Cleanings – This procedure is performed by a dental hygienist and only one side of the mouth can be deep cleaned per visit.
• Fillings – Typically only two fillings can be performed per visit
• Extractions – Only simple extractions. If it is a back tooth, the patient will be referred to an outside agency for a surgical extraction.

Accepted Documents for Proof of Income

To qualify for a sliding scale fee, you must provide proof of your gross annual household income. A “household” includes legal children, a civil union partner or married spouse, and legal dependents. Annual gross income includes salary, unemployment benefits, disability or social security benefits, investment income or other sources of income that support the household. You should bring proof of income for yourself and everyone in your household.

The following documents can be used for proof of income:

• Most recent tax return
• 2-3 most recent pay stubs from employer, no older than three months
• Most recent W-2 or 1099
  (Prior year W2 or 1099 will not be accepted as Proof of Income after June 30 of the current year)
• Letter from employer stating cash earnings that is signed by your employer or supervisor
• Letter from the Social Security Administration documenting your SSI or SSDI benefits
• Letter from the Social Security Administration documenting that you are ineligible for government benefits
• Letter detailing unemployment benefits from your state unemployment office
• Military Leave and earnings statement
• Notarized letter stating you have no source of income, signed by you