| Sliding Fee Discount Schedule at 2024 Federal Poverty Levels | ||||||
|---|---|---|---|---|---|---|
| 1) Find your Family Size and move across the row to the right to match your annual family income: | ||||||
| Family Size | Qualifying Income Ranges: (Low to high in each column) | |||||
| 1 | $0 - $15,060 | $15,061 - $18,825 | $18,826 - $22,590 | $22,591 - $26,355 | $26,356 - $30,120 | $30,121 + |
| 2 | $0 - $20,440 | $20,441 - $25,550 | $25,551 - $30,660 | $30,661 - $35,770 | $35,771 - $40,880 | $40,881 + |
| 3 | $0 - $25,820 | $25,821 - $32,275 | $32,276 - $38,730 | $38,731 - $45,185 | $45,186 - $51,640 | $51,641 + |
| 4 | $0 - $31,200 | $31,201 - $39,000 | $39,001 - $46,800 | $46,801 - $54,600 | $54,601 - $62,400 | $62,401 + |
| 5 | $0 - $36,580 | $36,581 - $45,725 | $45,726 - $54,870 | $54,871 - $64,015 | $64,016 - $73,160 | $73,161 + |
| 6 | $0 - $41,960 | $41,961 - $52,450 | $52,451 - $62,940 | $62,941 - $73,430 | $73,431 - $83,921 | $83,921 + |
| 7 | $0 - $47,340 | $47,441 - $59,175 | $59,176 - $71,010 | $71,011 - $82,845 | $82,846 - $94,681 | $94,681 + |
| 8 | $0 - $52,720 | $52,721 - $65,900 | $65,901 - $79,080 | $79,081 - $92,260 | $92,261 - $105,441 | $105,441 + |
| For Each Additional person, add | $5,380 | $6,725 | $8,070 | $9,415 | $10,760 | |
| 2) Follow DOWN the column where your income matches. Your family income falls in this column's range of the 2024 Federal Poverty level as indicated below. | ||||||
| Income At or Below: | Income Above: | |||||
| % Federal Poverty Level* | 0%-100% | 101%-125% | 126%-150% | 151%-175% | 176%-200% | 200% & greater |
| 3) Continue DOWN the same column. The Sliding Fee Discount Scale lowers your Fees as shown below: | ||||||
| Nominal Fee ($15) | Co-Pay $30.00 |
Co-Pay $45.00 |
Co-Pay $60.00 |
Co-Pay $75.00 |
No Discount | |