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CURRENT FORMS:
Family Size Slide A(<=100%) Slide B(101% - 125%) Slide C(126% - 150%) Slide D(151% - 175%) Slide E(176% - 200%) Above 200% FPL
From - To From - To From - To From - To From - To
1 $0 - $15,060 $15,061 - $18,825 $18,826 - $22,590 $22,591 - $26,355 $26,356 - $30,120 $30,121+
2 $0 - $20,440 $20,441 - $25,550 $25,551 - $30,660 $30,661 - $35,770 $35,771 - $40,880 $40,881+
3 $0 - $25,820 $25,821 - $32,275 $32,276 - $38,730 $38,731 - $45,185 $45,186 - $51,640 $51,641+
4 $0 - $31,200 $31,201 - $39,000 $39,001 - $46,800 $46,801 - $54,600 $54,601 - $62,400 $62,401+
5 $0 - $36,580 $36,581 - $45,725 $45,726 - $54,870 $54,871 - $64,015 $64,016 - $73,160 $73,161+
6 $0 - $41,960 $41,961 - $52,450 $52,451 - $62,940 $62,941 - $73,430 $73,431 - $83,920 $83,921+
7 $0 - $47,340 $47,341 - $59,175 $59,176 - $71,010 $71,011 - $82,845 $82,846 - $94,680 $94,681+
8 $0 - $52,720 $52,721 - $65,900 $65,901 - $79,080 $79,081 - $92,260 $92,261 - $105,440 $105,441+
FORMS & OTHER INFORMATION
BROAD TOP AREA MEDICAL CENTER, INC
2024 SLIDING FEE SCALE DISCOUNT PROGRAM-PATIENT EDUCATION & INTEREST FORM
FEDERAL POVERTY GUIDELINES
Broad Top Area Medical Center Inc., (BTAMC) is a non-profit Federally Qualified Health Center, our mission is to provide access to affordable, high-quality healthcare without discrimination based on race, color, sex, disability, age, creed, or national origin.
Family and Medical Leave Act (FMLA)
The Family and Medical Leave Act (FMLA) of 1993 is a United States labor law requiring covered employers to provide employees with job-protected, unpaid leave for qualified medical and family reasons.
BTAMC will provide in-scope services to all patients, regardless of their insurance ability to pay. Every patient may apply for our Sliding Fee Scale Discount Program (SFS) to determine qualification. Patients may choose to decline the benefit program.
Eligibility for Sliding Fee Discounts is based on the federal poverty level (FPL) income guidelines which are adjusted annually and operate in accordance with other federal program regulations. All patients are encouraged to apply. Uninsured and under-insured patients may qualify for the program based on their household size and their family's income. Sliding Fee Scale Discount Program applications are available at every BTAMC reception desk and on-line - visit www.broadtopmedical.com
Important discount program points are:
enrollment@broadtopmedical.com
2024 POVERTY GUIDELINES FOR THE 48 CONTIGUOUS STATES AND THE DISTRICT OF COLUMBIA
*For families/households with more than 8 persons, add $5,380 for each additional person.