Patient Payment
DHC accepts Medicaid, Medicare MSCAN, CHIPS, most private insurances and other third party payer sources..
Payment is expected at the time of service. However, a medical provider will see you regardless of your ability to pay. Cash, personal checks, money orders, and credit cards are acceptable forms of payment.
NOTE: If you are a new patient, please arrive 15 minutes early.

Sliding Fee Scale
If you do not have insurance and/or have low income, you may qualify for sliding fee discounts. Eligibility for discount is determined using the Department of Health and Human Services’ Poverty Guidelines. While you may sign a self-declaration of income upon your first visit, you must bring in proof of income before your second visit or you will be assessed the full charges for services.
Proof of income must be shown by:
Current pay stubs
Tax forms W-2 or 1099
Most recent profit and loss statements, if self-employed
Letter from your employer
Documents showing income from unemployment, social security disability or death benefits, alimony, child support, public assistance, pension, adoption assistance, divorce decree, separation agreement, or other court filed agreement with amount and length of agreement.
0% | 20% | 40% | 60% | 80% | 100% | |||||||
100% of FPL | 100.01 – 120% of FPL | 121.01 – 140% of FPL | 141.01 – 160% of FPL | 161.01 – 180% of FPL | 181.01 – 200% of FPL | |||||||
Family Size | From | To | From | To | From | To | From | To | From | To | From | To |
1 | $0 | $12,140 | $12,141 | $14,568 | $14,569 | $16,996 | $16,997 | $19,424 | $19,425 | $21,852 | $21,853 | $24,280 |
2 | $0 | $16,460 | $16,461 | $19,752 | $19,753 | $23,044 | $23,045 | $26,336 | $26,337 | $29,628 | $29,629 | $32,920 |
3 | $0 | $20,780 | $20,781 | $24,936 | $24,937 | $29,092 | $29,093 | $33,248 | $33,249 | $37,404 | $37,405 | $41,560 |
4 | $0 | $25,100 | $25,101 | $30,120 | $30,121 | $35,140 | $35,141 | $40,160 | $40,161 | $45,180 | $45,181 | $50,200 |
5 | $0 | $29,420 | $29,421 | $35,304 | $35,305 | $41,188 | $41,189 | $47,072 | $47,073 | $52,956 | $52,957 | $58,840 |
6 | $0 | $33,740 | $33,741 | $40,488 | $40,489 | $47,236 | $47,237 | $53,984 | $53,985 | $60,732 | $60,733 | $67,480 |
7 | $0 | $38,060 | $38,061 | $45,672 | $45,673 | $53,284 | $53,285 | $60,896 | $60,897 | $68,508 | $68,509 | $76,120 |
8 | $0 | $42,380 | $42,381 | $50,856 | $50,857 | $59,332 | $59,333 | $67,808 | $67,809 | $76,284 | $76,285 | $84,760 |
9 | $0 | $46,700 | $46,701 | $56,040 | $56,041 | $65,380 | $65,381 | $74,720 | $74,721 | $84,060 | $84,061 | $93,400 |
10 | $0 | $51,020 | $51,021 | $61,224 | $61,225 | $71,428 | $71,429 | $81,632 | $81,633 | $91,836 | $91,837 | $102,040 |
11 | $0 | $55,340 | $55,341 | $66,408 | $66,409 | $77,476 | $77,477 | $88,544 | $88,545 | $99,612 | $99,613 | $110,680 |
12 | $0 | $59,660 | $59,661 | $71,592 | $71,593 | $83,524 | $83,525 | $95,456 | $95,457 | $107,388 | $107,389 | $119,320 |