Sliding Fee Discount Program

H.E.A.L. Mississippi is a healthcare organization that offers a discount on certain services based on a household’s income and size. Sliding fee calculations are determined by using an applicant’s total household annual income and are based on the most recent Federal Poverty Guidelines to determine your eligibility.

If you wish to qualify for the sliding fee, you must show proof of income for all family members/individuals living in your household or individuals for whom you are financially responsible. If you do not have any source of income, please provide a brief, written statement explaining how you provide basic life essentials, food, and shelter.

Applicants should provide a copy of the following documents, if applicable:

• Previous year’s Federal Tax Return, W-2’s or 1099’s (Income will come from total income line)
• Most recent pay stubs spanning four weeks
• Social Security or Pension Income
• Public assistance award letters for each adult age 18 and over living in the household
• Unemployment compensation statement

Your household discount will be assessed once per year. You must reapply for the Sliding Fee Discount Program annually and provide updated income documentation at the time of reapplication.

Income is based annual earnings. Sliding Fee Scale Discount Program exclusions: labs, certain injections, some procedures, and certain medications. You will be notified in advance when exclusions apply.