A sliding scale sets what you pay by household income and size rather than by a fixed price. Federally qualified health centers use it as a matter of course, and NYC Health + Hospitals applies the same logic through its financial assistance policy.
Why it matters for the uninsured. It turns an unpredictable bill into a known number before the visit. At or below 200% of the federal poverty level in the public system that number is frequently zero; above it, the scale rises in bands rather than jumping to full price.
What to bring: proof of income — pay stubs, an employer letter, a tax return, or a written self-attestation if you are paid in cash. Cash work is common and there is a procedure for it. It is not a disqualifier.
Ask for it by name: “Do you have a sliding scale, and what documents do you need to set my level?” That question is the difference between a $0 visit and a full-price one.
Community health centers can be found by ZIP code through the federal directory at findahealthcenter.hrsa.gov.
Also called: sliding fee scale, income-based fee. Reference: Sliding scale fee on Wikipedia — general definition, not New York specifics.
More in Glossary of health coverage and billing terms
- Out-of-pocket maximum — The annual ceiling on what you pay for in-network covered care. After it, the plan pays 100%.
- Network (in-network and out-of-network) — The set of doctors and hospitals your plan has contracted with. Outside it, you pay much more.
- Formulary — The list of drugs a plan covers, sorted into tiers that determine what you pay.
This page explains how the system works. It is not medical advice. More.