Patient Resources
When applying for assistance, examples of income counted include (and are not limited to):
- Jobs
- Self-employment
- Pensions, dividends, interest
- Social Security or unemployment benefits
Common documents requested to verify income are:
- Most recently filed tax return (and attached schedules)
- IRS Form W-2 and 1099
- Current paystubs
- Social Security, disability, and pension benefits statements
- Unemployment benefits statement
- If you have no income, you will be asked to complete a self-declaration form detailing how you support yourself financially.
Approved Sliding Fee Discount Program applications are for a six-month period. If approved, you can then reapply with updated income verification documents after each award period ends. If your household situation or income changes, you are to report those changes. To apply for this program, simply contact us at 1-800-942-5420. We will assist you with our application process.
Outreach and Enrollment
You may be eligible for other health insurance such as private insurance through the Marketplace, Medical Assistance, BadgerCare Plus, Medicare, or veterans benefits. We understand it may be difficult to understand which program is available or appropriate for you. We have staff that are trained to help you and your family learn about the different programs. Please call 1-800-942-5420 to make an appointment with our staff at a time convenient for you.