Healthy Neighborhood Health Plan

 

This page explains the Healthy Neighborhood Health Plan
and provides the required forms to fill out and submit.

 
Does BCMC  offer specialized health plans? 

YES - Healthy Neighborhood Health Plan
 
u BCMC offers specialized health plans ~ Healthy Neighborhood Health Plan
u For patients that meet income guidelines
u Sponsored by the Federal Government
u Sliding fee scale for patients up to 200% of poverty based on family size
u The minimum co-pay is $15 and the maximum is $60
What is the Fee Schedule for Healthy Neighborhood Health Plan? 
 


Bland County Medical Clinic
Healthy Neighborhood Health Plan
Fee Schedule Effective July 1 2011
 
 
100% 101% -125% 126% -150% 151% -175% 176% -200%

Type A

  

  Type B       Type C    Type D   Type E      

Co-pay

    $ 15

   

$ 20

 

   $ 35

 

   $ 45

 

   $ 60  
 
 

Family
Size

                      
      1      0~10,890      10,891~13,613      13,614 ~ 16,335      16,336 ~ 19,058      19,059 ~ 21,780  
      2   0~14,710   14,711~18,388   18,389 ~ 22,065   22,066 ~ 25,743   25,744 ~ 29,420  
      3   0~18,530   18,531~23,163   23,164 ~ 27,795   27,796 ~ 32,428   32,429 ~ 37,060  
      4   0~22,350   22,351~27,938   27,939 ~ 33,525   33,526 ~ 39,113   39,114 ~ 44,700  
      5   0~26,170   26,171~32,713   32,714 ~ 39,255   39,256 ~ 45,798   45,799 ~ 52,340  
      6   0~29,990   29,991~37,488   37,489 ~ 44,985   44,986 ~ 52,483   52,484 ~ 59,980  
      7   0~33,810   33,811~42,263   42,264 ~ 50,715   50,716 ~ 59,168   59,169 ~ 67,620  
      8   0~37,630   37,631~47,038   47,039 ~ 56,445   56,446 ~ 65,853   65,854 ~ 75,260  
 


  Every effort has been made to insure the correct limits of this chart.
 The limits do change.

 
 
 If you are not sure of the proper income limit, please call Bland Clinic for confirmation.

Click here to view printable chart
 
 
 

Here is the FORM for the Healthy Neighborhood Health Plan

The form is in Adobe PDF format
(right click, save target as - to download to your computer)

Print document, fill out, and submit in person to BCMC..
BCMC_Agreement.pdf
  Sliding Fee Application .pdf