Client Ability to Pay
Fee Notice
It is the policy of A.W.A.R.E, Inc. to provide essential services regardless of the patient’s ability to pay. You or members of your family may be eligible for a SLIDING FEE discount based upon family income and size. If you cannot afford to pay for services, please request a Fee Waiver Application from your service team. No one will be denied access to services based on an inability to pay.
The Sliding Fee discount will apply to all services received at this location, but not those services which are purchased from outside of AWARE, such as laboratory testing or medications.
Discounts apply for one year. This form must be completed annually, or if your financial situation changes.
Please inquire with your AWARE representative or contact the Shared Resource Center if you have questions.
205 E. Park | Anaconda, MT 59711 | 406.563.8117 | Aware-inc.org
Sliding Fee Schedule
Use either the annual income table or the monthly income table. Find your family size, then compare your income with the amounts shown. FPL means Federal Poverty Level.
Annual Income Thresholds
On a phone or tablet, swipe left or right to view all columns.
| Family size | Up to 100% FPLClient pays 0% | Above 100% to 150% FPLClient pays 25% | Above 150% to 200% FPLClient pays 50% | Above 200% to 250% FPLClient pays 75% |
|---|---|---|---|---|
| 1 | $15,960 | $23,940 | $31,920 | $39,900 |
| 2 | $21,640 | $32,460 | $43,280 | $54,100 |
| 3 | $27,320 | $40,980 | $54,640 | $68,300 |
| 4 | $33,000 | $49,500 | $66,000 | $82,500 |
| 5 | $38,680 | $58,020 | $77,360 | $96,700 |
| 6 | $44,360 | $66,540 | $88,720 | $110,900 |
| 7 | $50,040 | $75,060 | $100,080 | $125,100 |
| 8 | $55,720 | $83,580 | $111,440 | $139,300 |
For family units with more than eight members, add $5,680 for each additional member.
Monthly Income Thresholds
On a phone or tablet, swipe left or right to view all columns.
| Family size | Up to 100% FPLClient pays 0% | Above 100% to 150% FPLClient pays 25% | Above 150% to 200% FPLClient pays 50% | Above 200% to 250% FPLClient pays 75% |
|---|---|---|---|---|
| 1 | $1,330 | $1,995 | $2,660 | $3,325 |
| 2 | $1,803 | $2,705 | $3,607 | $4,508 |
| 3 | $2,277 | $3,415 | $4,553 | $5,692 |
| 4 | $2,750 | $4,125 | $5,500 | $6,875 |
| 5 | $3,223 | $4,835 | $6,447 | $8,058 |
| 6 | $3,697 | $5,545 | $7,393 | $9,242 |
| 7 | $4,170 | $6,255 | $8,340 | $10,425 |
| 8 | $4,643 | $6,965 | $9,287 | $11,608 |
For family units with more than eight members, add $473 for each additional member.
If your income is above the amounts shown, please contact AWARE for information about fees and available assistance.
Good Faith Estimates
If you do not have health insurance or do not plan to use insurance for your care, you may ask for a Good Faith Estimate of the expected cost of scheduled services. Ask your AWARE service team or contact the Shared Resource Center.
If a bill is at least $400 more than your Good Faith Estimate, you may be eligible to dispute the bill. Learn more about your rights on the CMS Medical Bill Rights website.
Questions or assistance
Please contact your AWARE representative or the Shared Resource Center if you have questions, need help applying, or need this information in another language or accessible format.
205 E. Park, Anaconda, MT 59711
406.563.8117