• Sliding Fee Scale

Primary Health Network accepts all patients regardless of their insurance or financial status. We are a federally funded health care program which in turn allows us to offer a wide range of services to patients through the sliding-fee scale.

We offer the sliding-fee scale to all income eligible uninsured or under-insured patients based on annual household income for most of our services. Income guidelines and acceptable verification for the sliding-fee scale are as listed below.

If you have any additional questions, feel free to contact your physician's office or contact our Billing Department at 1.724.342.5313 or Contact Us.

How do I qualify?

If you wish to qualify for the Sliding Fee you MUST show proof of gross annual income for all immediate family members living in your household. Gross income is ALL income from ALL sources before taxes. Applicants should provide a copy of either two consecutive pay stubs, or the previous years income tax return or W-2 form.

Acceptable Income Verification

  • Recent Federal tax return
  • IRS form W-2 or 1099
  • (2) Current paystubs

How do I get started?

To begin the Sliding-Fee application process simply download the appropriate form below and take it with you to your next scheduled visit.

General ApplicationDental Application


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