| Canyonlands Community Health Care |
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Financial
Assistance Available
AHCCCS ENROLLMENT
Our financial counselors can help people with limited income to enroll in AHCCCS over the internet.
This provides faster processing and shorter wait times. There is no separate interview with an AHCCCS
or DES caseworker needed.
FAMILY HEALTH PLAN/SLIDING FEE PROGRAMS
Family Health Plan is designed to make quality health care available to people who lack adequate insurance and have limited income. Qualifying members of the Family Health Plan have access to all the quality health care services at Canyonlands Urgent Care and Lake Powell Medical Center at a reduced rate. Based on individual financial circumstances, the Plan allows members to pay variable rates from a minimum of $15.00, up to 75% of the office visit charges.
There is no charge for membership in the Family Health Plan. However, it is available only to those who meet the eligibility requirements. We recommend all patients who meet the requirements apply for the Family Health Plan, regardless of current insurance coverage, as the Plan may serve as a secondary payer on the balance due after insurance. If you want more information about the Family Health Plan, please ask to see our Patient Services Representative. To qualify for the Family Health Plan, an application must be completed and Proof of Income (most recent tax return, check stubs, Affirmation of Income, etc.) must be provided for verification.
To use the graph below, find your family size on the left, then find your household income on the right, follow the shaded column down to find the percentage you are required to pay.
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Family Size |
Annual Income |
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FROM TO |
FROM TO |
FROM TO |
FROM TO |
MORE THAN |
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1 |
0 9800 |
9801 13034 |
13035 16366 |
16367 19600 |
19601 |
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2 |
0 13200 |
13201 17556 |
17557 22044 |
22045 26400 |
26401 |
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3 |
0 16600 |
16601 22078 |
22079 27722 |
27723 33200 |
33201 |
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4 |
0 20000 |
20001 26600 |
26601 33400 |
33401 40000 |
40001 |
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5 |
0 23400 |
23401 31122 |
31123 39078 |
39079 46800 |
46801 |
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6 |
0 26800 |
26801 35644 |
35645 44756 |
44757 53600 |
53601 |
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7 |
0 30200 |
30201 40166 |
40167 50434 |
50435 60400 |
60401 |
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8 |
0 33600 |
33601 44688 |
44689 56112 |
56113 67200 |
67201 |
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9 |
0 37000 |
37001 49210 |
49211 61790 |
61791 74000 |
74001 |
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10 |
0 40400 |
40401 53732 |
53733 67468 |
67469 80800 |
80801 |
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B |
C |
D |
E |
F |
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Patient Portion |
0 to $15 minimum |
25% or minimum |
50% or minimum |
75% or minimum |
100% Full Payment |
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