Sliding Fee Discount Program

Policy Statement

Thrivewell, LLC is committed to ensuring equitable access to behavioral health services. In accordance with requirements established by the National Health Service Corps (NHSC) and the Health Resources and Services Administration (HRSA), Thrivewell maintains a Sliding Fee Discount Program (SFDP) that provides reduced fees for eligible patients.

The SFDP is based solely on household size and gross household income, as defined by the current Federal Poverty Guidelines (FPG), and is available to all patients regardless of insurance status.

Thrivewell will not deny services to any individual based on inability to pay.

Eligibility Criteria

Patients may qualify for discounted services if gross household income is at or below 200% of the Federal Poverty Level (FPL), adjusted for household size.

Eligibility determinations are based exclusively on:

Household size; and
Gross household income (income before taxes and deductions)

Discounts are applied uniformly and are not influenced by:

Diagnosis
Frequency or duration of services
Type of service provided
Patient ability to negotiate fees

Standard Fee

The standard fee for services is:

$175 per session

Sliding Fee Discount Schedule

Discounted fees are determined using gross monthly household income and household size, consistent with current FPL guidelines. Discounts are available for incomes at or below 200% FPL.

Household Size 1

≤100% FPL (≤ $1,330/month): $20 (nominal fee)
101–125% FPL ($1,331–$1,663/month): $40
126–150% FPL ($1,664–$1,995/month): $60
151–175% FPL ($1,996–$2,327/month): $85
176–200% FPL ($2,328–$2,660/month): $110
>200% FPL: $175

Household Size 2

≤100% FPL (≤ $1,803/month): $20 (nominal fee)
101–125% FPL ($1,804–$2,253/month): $40
126–150% FPL ($2,254–$2,705/month): $60
151–175% FPL ($2,706–$3,156/month): $85
176–200% FPL ($3,157–$3,607/month): $110
>200% FPL: $175

Household Size 3

≤100% FPL (≤ $2,277/month): $20 (nominal fee)
101–125% FPL ($2,278–$2,846/month): $40
126–150% FPL ($2,847–$3,415/month): $60
151–175% FPL ($3,416–$3,987/month): $85
176–200% FPL ($3,988–$4,553/month): $110
>200% FPL: $175

Household Size 4

≤100% FPL (≤ $2,750/month): $20 (nominal fee)
101–125% FPL ($2,751–$3,438/month): $40
126–150% FPL ($3,439–$4,125/month): $60
151–175% FPL ($4,126–$4,812/month): $85
176–200% FPL ($4,813–$5,500/month): $110
>200% FPL: $175

Household Size 5

≤100% FPL (≤ $3,223/month): $20 (nominal fee)
101–125% FPL ($3,224–$4,028/month): $40
126–150% FPL ($4,029–$4,833/month): $60
151–175% FPL ($4,834–$5,637/month): $85
176–200% FPL ($5,638–$6,447/month): $110
>200% FPL: $175

All monthly income amounts are rounded to the nearest dollar for administrative simplicity.

Nominal Fee Requirement

Patients with household income at or below 100% FPL will receive the maximum allowable discount. A nominal fee of $20 per session may be charged.

This nominal fee may be reduced or waived if it presents a barrier to accessing care.

Income Verification

To determine eligibility, Thrivewell requests documentation of household income. Acceptable forms include:

Recent pay stubs
Most recent federal tax return
Benefits award letters (e.g., Social Security, SSDI)
Other reasonable forms of income verification

If documentation is not reasonably available, self-attestation may be accepted and must be documented in the patient record.

Eligibility Determination and Renewal

Eligibility is determined at the time of intake
Eligibility must be reassessed at least annually
Reassessment will occur sooner if there is a reported change in household size or income

Application Process

Patients may request participation in the Sliding Fee Discount Program at any time.

To apply, patients must:

Request an SFDP application from Thrivewell; and
Indicate interest in the Sliding Fee Discount Program

Completed applications and supporting documentation will be reviewed promptly, and patients will be notified of eligibility determination.