Sliding Fees Program

 “Command them to do good, to be rich in good deeds, and to be generous and willing to share” 1 Timothy 6:18

We offer a sliding fee program for discounted care to those who have limited means to pay for their professional counseling services. We do not receive the type of federal funds that requires us to offer sliding scale fees, however, it is a part of our purpose to increase access to quality counseling care by making it more affordable. This program is designed to provide discounted care to those who have limited means to pay for their counseling services (uninsured or underinsured). To determine if the sliding fee program pertain to you, please explore the information below:

Please use the information on his page to determine whether you may want to submit an application or not. Individuals must complete the entire application for approval.

The application and all required supporting documents will be reviewed and a decision made regarding the level of adjustment to be assigned and your adjustment will be made in writing and requires your signature approval. In addition, all participants in the sliding fee program must re-apply annually with current proof of income.

To apply, please download the sliding fee program application found on this page, and complete the application in full. Use email or postal mail to return your signed copy of your completed application and copies of all your supporting documents. Please note that incomplete applications will not be processed.

Email: office@healccc.com
Fax: 540-301-2133
Postal Mail: HEAL CCC, PO Box 123, Mitchells, VA  22729
Questions: email office@healccc.com or call: 540-227-0018

The following supporting documents must accompany your completed application:
 
  1. Current Proof of Income for family/each household member: last year’s tax return, paycheck stubs (most recent 2 months required), most recent W-2 Forms, or benefit letters or statements that show proof of what you receive for social security, unemployment, workers compensation, child support, letter of attestation etc. 
  2. Identification: Driver’s License, State Identification, College or Work ID, Passport, etc.
  3. Proof of Address: Driver’s License, State Identification, Utility Bill, Bank Statement, Letter of Attestation, etc.

If you are interested in applying for the Sliding Fees program, please email our office at office@healccc.com or call the appointment line at 540-227-0018.

We do not receive the types of federals funds that require us to offer sliding scale fees, however, because it is part of our mission to increase access to quality care, we use the information provided in your application as well as federal poverty guidelines, household size, reported special circumstances, and income in creating and annually updating the sliding fees schedule below to determine eligibility.

The Income Chart and Fees Schedule tabs offer an estimate of the discounted fee that you may be eligible for and offers enough information to help you determine whether or not you’d like to complete an application. However, final fees will be determined by our office after verification of your completed application. If you have questions, please contact us at: email office@healccc.com or call: 540-227-0018.

% Discount
50%
40%
30%
Household/Family SizeLevel 1Level 2Level 3
1$32,805$58,320$87,480 
2$44,370$78,880$118,320 
3$55,935$99,440$149,160 
4$67,500$120,000$180,000 
5 $79,065$140,560$210,840 
6$90,630$161,120$241,680 
7$102,195$181,680$272,520 

 

 

 

 

 

 

 

 

 

 

For every additional person, add: $11,565

Intake Assessment Fees Schedule

Scale%
Discount
Discount Fee
Level 150%
$80.00
Level 240%
$96.00
Level 330%
$112.00
Full Rate 0%$160.00

 

 

General Appointment Fee Schedule (Standard, 53-60 min)

Scale%
Discount
Discount Fee
Level 150%
$77.50
Level 240%
$93.00
Level 330%
$108.50
Full Rate 0%$155.00