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Sliding Fee Scale Therapy Services For Those Needing Financial Assistance

The Sliding Fee Scale (SFS) programs are for those individuals who are living at or near the Federal Poverty Line (see guidelines below for details on if you qualify). Individuals living with homelessness and unemployment are served for FREE at Forefront Therapy-The Bronstein Clinic! Please see below charts for information and guidance surrounding our SFS programs and how we provide financial assistance for those respected members of our community. Also, please call us with any questions surrounding how you can apply for, use, and/or help support the existence of these programs!

Federal Poverty Guideline

*number of individuals living in your household, if any

Using the number of individuals living in your household, hover over the section of the graph and you will see what the income level is based on Federal Poverty Guidelines. Then, use this number to help calculate and understand which program you may fit in based off of the charts below. Once that is understood, then you will get an idea of the session costs and how much financial aid Forefront is able to offer you!


Calculating Your Percentage off of the Federal Poverty Line

Poverty Level B
At or below 100%
C
101%-125%
D
126%-150%
E
151%-175%
F
176%-200%
Above
200%
Family of 1
$0 - $15,060
$15,061 - $18,825
$18,826 - $22,590
$22,591 - $26,355
$26,356 - $30,120
$30,121+
Family of 2
$0 - $20,440
$20,441 - $25,550
$25,551 - $30,660
$30,661 - $35,770
$35,771 - $40,880
$40,880+
Family of 3
$0 - $25,820
$25,821 - $27,450
$27,451 - $38,730
$38,731 - $45,185
$45,186 - $51,640
$51,641+
Family of 4
$0 - $31,200
$31,201 - $39,000
$39,001 - $46,800
$46,801 - $54,600
$54,601 - $62,400
$62,401+
Family of 5
$0 - $36,580
$36,581 - $45,725
$45,726 - $54,870
$54,871 - $64,015
$64,016 - $73,160
$73,161+
Family of 6
$0 - $41,960
$41,961 - $52,450
$52,451 - $62,940
$62,941 - $73,430
$73,431 - $83,920
$83,921+
Family of 7
$0 - $47,340
$47,341 - $59,175
$59,176 - $71,010
$71,011 - $82,845
$82,846 - $94,680
$94,681+
Family of 8
$0 - $52,720
$52,721 - $65,900
$65,901 - $79,080
$79,081 - $92,260
$92,261 - $105,440
$105,441+
For each additional person past 8, add
$4,540
$5,675
$6,810
$7,945
$9,080
$9,080


Sliding Fee Scale (SFS) Program for the Uninsured

*Divide your projected annual income by the Federal Poverty Line income number that you collected in the chart above (based off of number of individuals in household). What percentage you have then places you in the program below. Please hover over the correct bar to see what your discounted SFS copay will be per session. For example, if you have 2 individuals in your household, the Federal Poverty Line is at $16,910. If you make $20,000 per year, that is 118% of the Federal Poverty Line, fitting you in the SFS Uninsured 28 program. Your daily copay would be $28 per session. This is, on average, a 77% discount on services provided.
Percent of Annual Household Income
SFS
Uninsured 0
SFS
Uninsured 12
SFS
Uninsured 28
SFS
Uninsured 44
SFS
Uninsured 60
SFS
Uninsured 76
SFS
Full 40
SFS
Full 60
0%
1-100%
101-125%
126-150%
151-175%
176-200%
>200%
>200%
  • SFS Full Pay 40 minute session: >200% Federal Poverty Line, $120 per session copay, no discount

  • SFS Full Pay 60 minute session: >200% Federal Poverty Line, $160 per session copay, no discount

*SFS Uninsured is named by the cash-based rate due per visit by the patient who is uninsured.


Sliding Fee Scale (SFS) Program for the Commercially Insured

*Using the same percentage method as the SFS Uninsured calculation, divide your annual income by the Federal Poverty Line annual income based on how many individuals live in your household (see Federal Poverty Line chart above). Based on that percentage, hover over the graph and discover the amount of your services will pay off of your deductible as financial aid. For example, if you have 2 individuals in your household, the Federal Poverty Line is at $16,910. If you make $20,000 per year, that is 118% of the Federal Poverty Line, fitting you in the SFS Commercial 60 program. Forefront will pay 60% of the services provided until deductible has been met. You would owe 40% of services provided. Not only is this a major discount, yet it also helps pay down your annual deductible as well, setting you up for more support if other services are needed in the future!
Percent of Annual Household Income
SFS
Commercial 75
SFS
Commercial 60
SFS
Commercial 45
SFS
Commercial 30
SFS
Commercial 15
1-100%
101-125%
126-150%
151-175%
176-200%

*Anyone over 200% of the Federal Poverty Guideline will pay in full at First Street Clinic.

**SFS Commercial is named on the percentage covered by Forefront Community Therapy. (i.e. SFS Commercial 75 will have 75% of total due bill will be covered and paid by Forefront Community Therapy with the patient financial responsibility of 25% of the total due bill, following insurance payment and adjustment).

***Commercial Insurances accepted in the SFS Commercial Program: Anthem BCBS, Humana, CareSource Marketplace, Ambetter by MHS

The sliding fee schedule shows the discounts allowed for Forefront patients who meet the criteria for income level. If you have any changes in income status, bring in new income information at your next appointment. 

CRITERIA: you must provide proof of income each calendar year or as changes in income occur, otherwise your visit will be FULL PRICE. Federal Poverty Guidelines, used to create these standards, will be updated as guidelines are available and published.

Good Faith Estimate

You have the right to receive a “good faith estimate” explaining how much your physical therapy will cost.

Under federal law, patients who don’t have insurance or who are not using insurance are entitled to receive a Good Faith Estimate (GFE) of the expected charges for medical items and services.

You have the right to receive a GFE for the total expected cost of any non-emergency items or services you receive at Forefront Therapy - Bronstein Clinic.  

You have the right to receive a GFE in writing prior to your scheduled appointment. If you schedule an appointment more than 10 business days in advance, or request a GFE without scheduling an appointment, Forefront Therapy has 3 business days to provide it.

If you schedule an appointment between 3 and 9 business days in advance, Forefront Therapy has 1 business day to provide the GFE.

If you are uninsured or not using your insurance to pay for your health care services and receive a bill that is at least $400 more than your GFE, you can dispute the bill.

Make sure to save a copy or picture of your GFE.

For questions or more information about your right to a GFE, visit www.cms.gov/nosurprises or call No Surprises Help Desk at 1-800-985-3059.