Sliding Fee Scale

Caswell Family Medical Center offers a “Sliding Fee Scale” for those who qualify.

WHAT IS CFMC’S SLIDING FEE?

Our Sliding Fee is a program designed to help lower your costs for medical visits at CFMC. Patients that have insurance may apply for the Sliding Fee Discount to help lower costs for non-covered services.

HOW MUCH DOES IT COST ME?

Your cost is based upon how much money you make or receive and the number of people in your household. Based on this information, your costs may be $20, $35, $50, $65, or $80 for a medical visit.

HOW DO I QUALIFY?

In order to be placed on the Sliding Fee Program, you must complete an application and provide the following documentation within 5 days of the application if you do not have it at the time you apply. If no income information is received, then patient will be responsible for full amount of bills incurred.

• Income verification which includes 1 month (four weeks) of recent pay checks.
• Verification of social Security benefits (not check), SSI, alimony, child support, retirement, unemployment, etc.
• Verification of any income that comes into you home and copies of all checks.
• If no income a letter from Social Services concerning assistance received or not received (Medicaid).

IS THERE ANYTHING THAT IS NOT COVERED?

Everything within our scope of service Is covered.

WHAT ARE THE RULES?

The Sliding Fee Program has these rules that must be followed in order to stay on the program:
• In order for your Sliding Fee to stay in effect, you must make payment at the time of your office visit. If you fail to do so you can be terminated from the Sliding Fee Program.
• In order to remain on the Sliding Fee Program, you must re-apply every 12 months. You will receive a letter from CFMC every 12 months asking you to bring information in to re-apply.
• Report any changes of income within five (5) working days.
• You can received 340B (discount prescriptions) pricing on your medications at Yanceyville Drug Store (336-694-9323)

FOR MORE INFORMATION:

Call our Sliding Fee Representative at 336-694-1181 (ext. 206)

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