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Self Pay Program for Uninsured Patients

The Betty Jean Kerr People’s Health Centers (PHC) is committed to providing comprehensive primary health care to the residents of St. Louis metropolitan area – regardless of their ability to pay.

Sliding Fee Information

Betty Jean Kerr People’s Health Centers (PHC) offers discounted healthcare services on a sliding fee scale. The amount of the discount is based on your family size and income, and can be fully discounted if you fall below 100% of the federal poverty guideline. There is a nominal fee based on discount level:

  • Level A: $20 fee for Medical, $50 fee for Dental and Podiatry
  • Level B: $25 fee for Medical, $55 fee for Dental and Podiatry
  • Level C: $30 fee for Medical, $60 fee for Dental and Podiatry
  • Level D: $35 fee for Medical, $65 fee for Dental and Podiatry
  • Level E: Full charge of rendered services

To qualify for the sliding fee scale, one of the following documents as proof of income is required and must be dated less than 30 days prior to your date of service:

  • One recent check stub & picture identification
  • Last year’s tax return (not valid after April 15th of current year unless you are self employed. Schedule C section of tax return is needed, if you are self employed)
  • A letter from the Division of Employment (unemployment statement)
  • Current W-2 forms (Self Employed patients only or schedule C section of tax returns)
  • Document reflecting child support or alimony
  • Food Stamps award letter
  • Social Security/Disability award letter
  • Current 12 credit hour schedule for full time students or 9 credit hour for graduate students.

If you qualify for the sliding fee scale, you will pay the nominal $ fees listed above at the time of the visit.

*The fee increases to $75.00 if you do not bring proof of income. After the visit, you will receive a bill for the remaining balance (if applicable).

Sliding Fee Discounts at a Glance

Federal Poverty Guidelines
Sliding Fee Scale
Effective April 1, 202
3

Size of Family Unit100%101-133%134-166%167-200%201%
100% Discount75% Discount50% Discount25% Discount0% Discount
Minimum Fee$20 Medical
$50 Dental & Podiatry
$25 Medical
$55 Dental & Podiatry
$30 Medical
$60 Dental & Podiatry
$35 Medical
$65 Dental & Podiatry
100% Pay
10 – 14,58014,581 – 19,39119,392 – 24,20324,204 – 29,160Over 29,161
20 – 19,72019,721 – 26,22826,229 – 32,73532,736 – 39,440Over 39,441
30 – 24,86024,861 – 33,06433,065 – 41,26841,269 – 49,720Over 49,721
40 – 30,00030,001 – 39,90039,901 – 49,80049,801 – 60,000Over 60,001
50 – 35,14035,141 – 46,73646,737 – 58,33258,333 – 70,280Over 78,281
60 – 40,28040,281 – 53,57253,573 – 66,86566,866 – 80,560Over 80,561
70 – 45,42045,421 – 60,40960,410 – 75,39775,398 – 90,840Over 90,841
80 – 50,56050,561 – 67,24567,246 – 83,93083,931 – 101,120Over 101,121
Each add’l member, add:$5,140$5,140$5,140$5,140$5,140
** Minimum fee is paid by all self pay patients regardless of where your income falls on this scale

Fees to Pay

 Medical Office Visit
(Including In-house labs & x-rays)
Dental & Podiatry Office Visit
A: <100%$20$50
B: 101%-133%$25$55
C: 134%-166%$30$60
D: 167%-200%$35$65
E: >201%100% of bill100% of bill
**Sliding fee discounts are applied based on family size and total annual income. See sliding fee scale. In-house labs & x-rays performed on separate date of medical visit will be charged the minimum fee.

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