If you don’t have insurance or can’t afford your insurance copayments, we can help. You may be able to pay less, depending on:
- The number of people in your household
- Your income
If you don’t qualify for a sliding fee, you can save by paying directly when you receive services.
Call to Get Started
Call a Financial Aid Coordinator before your next appointment at 913-648-2266. Here’s a list of the documents you will need.
- Sliding Fee Discount Program Application (located in our Patient Forms page.)
- Insurance card
- Photo ID
- Proof of address
If not insured, documents showing one month’s worth of household income.
- Most recent paystubs to equal 30 days
- Most recent annual federal income tax return
- Documentation of government assistance:
- Unemployment compensation
- SRS cash assistance
- Social Security or SSI
- Disability determination with benefit amount
- Documentation of child support/ alimony
- Letter on employer letterhead, signed and dated by supervisor
- Financial award letter showing grants, scholarships, fellowships, or assistantships (Loans are not considered as income)
- Self-Employed: Submit detail of the most recent three months of income and expenses for the business.
Adequate information must be made available to determine eligibility. Please submit a notarized letter from the individual assisting you financially and include the monthly monetary amount provided. In addition, we are unable to accept W-2s.
Note: HPC requires re-verification of household size and income every 12 months – or earlier if there is a change.
More About the Sliding Fee Discount Program (English | Spanish)
Insurance + Other Services
We can help you apply for a Health Insurance Marketplace plan or for Medicaid. And we can help you apply for our Sliding Fee Discount Program.