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Frequently Asked Questions

How do I know if I qualify? 
Your eligibility is determined by household income and size. If you are at or below 200% of the Federal Poverty Income Level, as defined by the U.S Department of Health & Human Services Poverty Guidelines, you are eligible for the SFS Discount, which will be determined based upon your household income and household size.  

What level of discount am I eligible to receive? 
If you qualify, the size of your discount will be determined by your income level in relationship to the federal poverty level. Please see the table below for a breakdown of discounts by income level.  

How and when do I apply? 
To receive financial assistance, you must complete the required Application for Financial Discount. This application can be completed in person at our clinic or online in advance of an appointment.  

As part of the application, you will be asked to verify your income and family size. The following documents, in order of preference, will be accepted as verification of income: 

• Pay stubs or a letter from an employer
• Full tax return if self-employed 
• Washington State Employment Security documentation 
• Self-attestation of presence or absence of income; any mark on the form can count as your signature. 

Once our staff have received your application and completed the verification process, we will mail you a letter containing the application decision and next steps. 

When will I need to reapply? 
You are required to reapply and re-verify income at least once per year. If you have not submitted a new application within 12 months, you will be prompted to reapply when you come in for your next visit.

What if my situation changes? 
As a patient, you are responsible for ensuring the validity of the information you share with us. Please submit a new application any time your coverage status, family income status, or household size changes.  

How does my insurance status affect my eligibility?

• If you are uninsured: All relatives can receive care at SIHB, no matter their ability to pay. We ask that uninsured patients meet with one our Enrollment Specialists to explore options to cover their care.  If you are uninsured and choose not to apply for insurance or the SFS, we will request payment.  

• If you are insured: Relatives insured under Medicare and private insurance are eligible for the SFS Discount.  

• If you are a Title V verified patient: You are not required to apply for Financial Assistance. However, while Title V covers services at our clinic, it is not a form of insurance. In the event you need a referral for another specialty clinic or emergency services, those services would not be covered by Title V. Enrolling in an insurance plan will give you more flexibility in the event you need extra services. Enrolling in an insurance plan also helps SIHB get reimbursed for the services we provide. This strengthens the work we do in the community and extends our Traditional Medicine services and other cultural programming. 

Are there any exceptions to the SFS Discount policy? 
Dental Lab nominal fees are not eligible for sliding fee scale discounts. 

How does SIHB define “income” and “household income?” 

• Income is defined as gross income not including legally excludable tribal income. Child support is not included in income. SIHB will consider income based on the most recent 90 days that can be verified. 
• Household income is defined as IRS dependent(s) that could be claimed on a tax return.   

How does SIHB define “dependents?” 
Unmarried adults are considered independent of themselves for income unless they can be considered a dependent according to the IRS dependent relative test. Grandchildren can be claimed in family size if they can be claimed as an IRS dependent. 

Where do patients find out about the SFS Discount? 
We inform our patients about the SFS Discount through initial registration, the SIHB patient handbook, and patient billing.