HAWC
Sliding Fee Scale Effective 07/01/08
Annual Income
| FAMILY | FROM | TO | FROM | TO | FROM | TO | FROM | TO | MORE |
| SIZE | THAN | ||||||||
| 1 | 0 | 10400 | 10401 | 13000 | 13001 | 15600 | 15601 | 20800 | 20800 |
| 2 | 0 | 14000 | 14001 | 17500 | 17501 | 21000 | 21001 | 28000 | 28000 |
| 3 | 0 | 17600 | 17601 | 22000 | 22001 | 26400 | 26401 | 35200 | 35200 |
| 4 | 0 | 2100 | 21201 | 26500 | 26501 | 31800 | 31801 | 42400 | 42400 |
| 5 | 0 | 24800 | 24801 | 31000 | 31001 | 37200 | 37201 | 49600 | 49600 |
| 6 | 0 | 28400 | 28401 | 35500 | 35501 | 42600 | 42601 | 56800 | 56800 |
| 7 | 0 | 32000 | 32001 | 40000 | 40001 | 48000 | 48001 | 64000 | 64000 |
| 8 | 0 | 35600 | 35601 | 44500 | 44501 | 53400 | 53401 | 64000 | 64000 |
| 9 | 0 | 39200 | 39201 | 49000 | 49001 | 58800 | 58801 | 78400 | 78400 |
| 10 | 0 | 42800 | 42801 | 53500 | 53501 | 64200 | 64201 | 85600 | 85600 |
| Patient | |||||||||
| Pays | $40.00 | $50.00 | $60.00 | $70.00 | 100% | ||||
The patient is always responsible for some part of the bill. If the percentage is less than our minimum charge the patient will pay the minimum.
|
MINIMUM QUALIFIES FOR PFIZER DRUG PROGRAM |
Sliding Fee Scale Effective 07/01/08
Monthly Income
| FAMILY | FROM | TO | FROM | TO | FROM | TO | FROM | TO | MORE |
| SIZE | THAN | ||||||||
| 1 | 0 | 867 | 868 | 1083 | 1084 | 1300 | 1301 | 1733 | 1733 |
| 2 | 0 | 1167 | 1168 | 1458 | 1459 | 1750 | 1751 | 2333 | 2333 |
| 3 | 0 | 1467 | 1468 | 1833 | 1834 | 2200 | 2201 | 2933 | 2933 |
| 4 | 0 | 1767 | 1768 | 2208 | 2209 | 2650 | 2651 | 3533 | 3533 |
| 5 | 0 | 2067 | 2068 | 2583 | 2584 | 3100 | 3101 | 4133 | 4133 |
| 6 | 0 | 2367 | 2368 | 2958 | 2959 | 3550 | 3551 | 4733 | 4733 |
| 7 | 0 | 2667 | 2668 | 3333 | 3334 | 4000 | 4001 | 5333 | 5333 |
| 8 | 0 | 2967 | 2968 | 3708 | 3709 | 4450 | 4451 | 5933 | 5933 |
| 9 | 0 | 3267 | 3268 | 4083 | 4084 | 4900 | 4901 | 6533 | 6533 |
| 10 | 0 | 3567 | 3568 |