Sliding Fee Discount Program (NHSC/HRSA)

Intro
Thrivewell Solutions is committed to ensuring access to care. In accordance with National Health Service Corps (NHSC) / Health Resources and Services Administration (HRSA) requirements, we offer a Sliding Fee Discount Program (SFDP) for self-pay services based on household size and gross household income using the current Federal Poverty Guidelines (FPG).

No one will be denied services due to inability to pay.

Who Can Apply
You may qualify for a reduced fee if your gross household income is at or below 200% of the Federal Poverty Level (FPL), based on household size. Sliding Fee Discounts are determined only by:

• Household size, and

• Gross household income (income before taxes)

Discounts are applied uniformly and are not based on diagnosis, frequency of appointments, anticipated length of treatment, or ability to negotiate rates.

Standard Fee
Standard self-pay rate: $175 per session

Sliding Fee Discount Table (Gross Monthly Household Income)
(Discounts available at or below 200% FPL)

Household Size 1

• ≤100% FPL (≤ $1,304/month): $25/session

• 101–125% FPL ($1,305–$1,630/month): $40/session

• 126–150% FPL ($1,631–$1,956/month): $60/session

• 151–175% FPL ($1,957–$2,282/month): $85/session

• 176–200% FPL ($2,283–$2,608/month): $110/session

• 200% FPL: $175/session

Household Size 2

• ≤100% FPL (≤ $1,763/month): $25/session

• 101–125% FPL ($1,764–$2,203/month): $40/session

• 126–150% FPL ($2,204–$2,644/month): $60/session

• 151–175% FPL ($2,645–$3,084/month): $85/session

• 176–200% FPL ($3,085–$3,525/month): $110/session

• 200% FPL: $175/session

Household Size 3

• ≤100% FPL (≤ $2,221/month): $25/session

• 101–125% FPL ($2,222–$2,776/month): $40/session

• 126–150% FPL ($2,777–$3,331/month): $60/session

• 151–175% FPL ($3,332–$3,886/month): $85/session

• 176–200% FPL ($3,887–$4,442/month): $110/session

• 200% FPL: $175/session

Household Size 4

• ≤100% FPL (≤ $2,679/month): $25/session

• 101–125% FPL ($2,680–$3,349/month): $40/session

• 126–150% FPL ($3,350–$4,019/month): $60/session

• 151–175% FPL ($4,020–$4,688/month): $85/session

• 176–200% FPL ($4,689–$5,358/month): $110/session

• 200% FPL: $175/session

Household Size 5

• ≤100% FPL (≤ $3,138/month): $25/session

• 101–125% FPL ($3,139–$3,922/month): $40/session

• 126–150% FPL ($3,923–$4,706/month): $60/session

• 151–175% FPL ($4,707–$5,491/month): $85/session

• 176–200% FPL ($5,492–$6,275/month): $110/session

• 200% FPL: $175/session

Monthly figures are rounded to the nearest dollar for ease of use.

Nominal Fee (≤100% FPL)
Individuals and families at or below 100% FPL receive the maximum discount. A nominal fee may be charged and may be adjusted if it would create a barrier to care.

Income Verification
We request one of the following to determine eligibility:

• Recent pay stubs

• Most recent tax return

• Benefits award letter (e.g., Social Security/SSDI)

• Other reasonable documentation

If documentation is not available, self-attestation may be accepted and documented in your record.

Eligibility Duration
Eligibility is determined at initial intake and reassessed at least annually, or sooner if your income or household size changes.

How to Apply
To request a Sliding Fee Discount Program application, contact us and include that you are interested in the Sliding Fee Discount program.