FORMS & OTHER INFORMATION

Important discount program points are:

• The Sliding Fee Scale provides significant discounts for BTAMC Medical and Dental services at every BTAMC location.
• The Sliding Fee Scale is not an insurance program—it is a benefit offered to ALL patients.
• The Sliding Fee Scale benefit year is from March 1st to the last day of February.
• Your eligibility is based only on your household size and the gross income for your household.
• You may qualify for the program, even if you have third-party medical insurance and/or dental coverage.
• You will qualify if your household income is below and/or up to 200% of the federal poverty level.
• You must apply for the program to determine eligibility for Sliding Fee Scale Discounts.
• You must provide proof of income along with your application such as tax forms or pay stubs or bank statements
• You are encourage to re-apply anytime your household income or household size changes, such as when someone loses insurance, someone becomes unemployed, or if you add or lose a family member - even when the change is temporary
• You must renew application and submit proof of income each year.
• Applications & questions can be submitted to the office in person, by mail or via secure Email to: enrollment@broadtopmedical.com.