Fee Discount Program Information
What is the Fee Discount Program?
The Health Center provides discounts on services to patients who are eligible for our Fee Discount Program. The fee discount can help you pay for costs not covered by your insurance.
What are the Income Guidelines?
Family Size ~ Max. Income
1 ~ $24,980
2 ~ $33,820
3 ~ $42,660
4 ~ $51,500
5 ~ $60,340
6 ~ $69,180
7 ~ $78,020
8 ~ $86,860
Updated May 2019
How do I apply?
Complete the Fee Discount Program application.
Fee Discount Application
All information you provide us in your application is kept completely confidential.
The following must be attached:
– Proof of current family income (paycheck stubs, copies of unemployment checks, Social Security award letters, child support, etc.)
– If you are zero income, you will need to provide a letter of support from the person that is supporting you or a self written statement of how you meet your basic needs.
– If you are self-employed, please complete the self-employment sheet (three months profit/loss).
If there are special issues you would like us to consider when we review your application, please write them on a separate piece of paper.
Return your completed application form with attachments to the health center, either in person or by mailing to:
Outreach & Enrollment
Sacopee Valley Health Center
70 Main Street, Porter, ME 04068
You can also fax paperwork to:
Attention: Outreach & Enrollment (207) 625-7820
What Services are Covered?
Most Health Center services are covered, including medical, counseling, optometry and dental appointments. These are discounted at the same fee depending where you fall on the income guidelines. You will receive a letter explaining the fee amounts for which you qualify.
Other Benefits of our Fee Discount Program:
– Enrollment in the SunRx prescription discount program.
– Discounts on some services provided through MaineHealth hospital free care program.
– Discounts on NorDx Lab Services provided at the Health Center.
Once you are enrolled, you will receive more specific information about these benefits.
When can I apply?
You can apply for the Fee Discount Program at any time. Once you qualify, your enrollment generally lasts for one year. Please submit a new application before your expiration date to avoid a gap in fee discount coverage.
For more information call:
Outreach & Enrollment Specialist