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At ACHR, we have reduced fee discount program for our uninsured patients for both medical and dental services. This discount is based on your annual income and household size. Patient will pay either $20 (medical) or $40 (dental) or % of cost; whichever is greater. You must bring income verification with you to your first office visit in order to be placed on the discount program.
Medical Reduced Fee Discount Program
| Pt. pays |
$20 |
>$20 or 20% |
>$20 or 40% | >$20 or 60% | >$20 or 80% | Full cost |
| Annual Income | ||||||
|
Household Size |
A | B | C | D | E | |
| 1 | $10,400 | $13,000 |
$15,600 | $18,200 |
$20,800 |
$20,801 |
| 2 | $14,000 | $17,500 | $21,000 | $24,500 | $28,000 |
$28,001 |
| 3 | $17,600 | $22,000 | $26,400 |
$30,800 |
$35,200 |
$35,201 |
| 4 | $21,200 | $26,500 |
$31,800 | $37,100 |
$42,400 |
$42,401 |
| 5 | $24,800 | $31,000 |
$37,200 |
$43,400 |
$49,600 | $49,601 |
| 6 | $28,400 | $35,500 |
$42,600 |
$49,700 | $56,800 |
$56,801 |
| 7 | $32,000 | $40,000 |
$48,000 |
$56,000 | $64,000 | $64,001 |
| 8 | $35,600 | $44,500 | $53,400 | $62,300 |
$71,200 |
$71,201 |
Dental Reduced Fee Discount Program
| Pt. pays | $40 |
>$40 or 25% | >$40 or 50% | >$40 or 75% | Full cost |
| Annual Income | |||||
| Household Size | A | B | C | D | E |
| 1 | $10,400 | $13,832 | $17,264 |
$20,800 |
$20,801 |
| 2 | $14,000 | $18,620 |
$23,240 | $28,000 | $28,001 |
| 3 | $17,600 | $23,408 | $29.216 | $35,200 | $35,201 |
| 4 | $21,200 |
$28,196 | $35,192 | $42,400 |
$42,401 |
| 5 | $24,800 |
$32,984 |
$41,168 | $49,600 | $49,601 |
| 6 | $28,400 | $37,772 |
$47,144 | $56,800 | $56,801 |
| 7 | $32,000 |
$42,560 | $53,120 | $64,000 | $64,001 |
| 8 | $35,600 | $47,348 |
$59,096 |
$71,200 | $71,201 |