City Prime Health offers access to quality health care for patients who don’t have insurance or don’t have enough insurance through a sliding fee discount program, with discounts available based on your current family size and income. The program can cover you for up to 12 months—a new application is required yearly or when your family size and income changes, whichever is sooner.

If you are currently enrolled as a patient at City Prime Health, stop by your doctor's office to inquire about the program.

Income guidelines:
The income guidelines for program eligibility are set based on the federal poverty level and a patient’s household size, as shown below.

Download the Sliding Fee Schedule 2022

Program restrictions
The following items are not covered under the sliding fee scale program:

    Prescriptions
    Co-pays
    Co-insurance
    Deductibles
    Personal items (e.g., telephone, private room differential, guest meals, etc.)

Necessary Documents

Application

Photo ID

    Driver's License

    Government-issued Identification Card/Passport

Wages and Salary

    Paycheck Stub (4 Consecutive Pay Periods)

    Current Income Tax Return

Self-Employed

    Signed and Dated Federal & NYS Income Tax Return and All Schedules

    Records of Earnings and Expenses

Social Security

    Award Letter

    Benefit Letter

Insurance Status

    A NY State Medicaid, Family Health Plus or Child Health Plus determination, if applicable.

Unemployment Benefits

    Award Letter

    Benefit Check

Child Support/ Alimony

    Letter from Court

    Child Support/ Alimony Check Stub

Workers Compensation

    Award Letter

    Check Stub