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Financial Assistance

Shawnee Financial Assistance Program

 

We are able to provide discounts for services provided at our health centers.  This is made possible through grant funding from the US Public Health Service, Bureau of Primary Health Care.

 

These discounts can be used by:

  • people who are uninsured
  • people with insurance who are eligible (qualified)

 

Individuals and families are encouraged to apply for this assistance.  Eligibility is based on family size and family’s income before taxes and deductions.  Discounts apply only to services provided at Shawnee Health Care locations.

 

An application form must be completed and requires proof of income (see Documents).  You can find the application here.

 

We can assist you with completing the application. Just call (618) 519-9200 or speak with a staff member at the front desk of any of our health centers.

 

Processing may take up to 2 business days.  Nominal (very small sum) Fees are due at the time of service.

 

No individual will be denied essential services due to inability to pay.

Documents

Required:

Identification for each adult family member, 18 and older, seeking discount

Proof of family size

  • tax return OR
  • attestation form

Proof of income for all family members, such as:

  • any income claimed on taxes
  • attestation form
  • 4 consecutive pay stubs
  • social security/disability letter
  • pension (1099 or letter showing the amount)
  • workers’ compensation
  • job reimbursement
  • child support
  • alimony
  • life insurance
  • trust fund
  • railroad benefits
  • veterans benefits
  • retirement benefits

 

Optional:

Attestation Form IF you are an adult who —

  • is unemployed supported by another adult
  • works seasonally or intermittently
  • is paid in cash
  • is homeless
  • has SSA/Disability as only income
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