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 April 1 2009
 
 

Type A

  

  Type B     Type C    Type D   Type E      

Co-pay

    $ 15

   

$ 20

 

   $ 35

 

   $ 45

 

   $ 60    
 
 

Family
 Size

                        
      1      0~10,830      10,831~13,538      13,539~16,245      16,246~18,953      18,954~21,660    
      2   0~14,570   14,571~18,213   18,214~21,855   21,856~25,498   25,499~29,140    
      3   0~18,310   18,311~22,888   22,889~27,465   27,466~32,043   32,044~36,620    
      4   0~22,050   22,051~27,563   27,564~33,075   33,076~38,588   38,589~44,100    
      5   0~25,790   25,791~32,238   32,239~38,685   38,686~45,133   45,134~51,580    
      6   0~29,530   29,531~36,913   36,914~44,295   44,296~51,678   51,679~59,060    
      7   0~33,270   33,271~41,588   41,589~49,905   49,906~58,223   58,224~66,540    
      8   0~37,010   37,011~46,263   46,264~55,515   55,516~64,768   64,769~74,020    
 


  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 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