The Sliding Fee Program
All patients are encouraged to apply for the Sliding Fee Program, which means that fees will be charged to patients based on their income and family size. These nominal fees are based on the guidelines provided annually by the federal government. To apply and qualify for the Sliding Fee Program you will need to fill out the Sliding Fee Application and return it to Health West with your documentation.
How to determine your slide
To find the sliding fee level you qualify for, you’ll first need to know your household’s annual income. For the most accurate calculation, refer to the Sliding Fee Application, which includes a list of income sources and documents that will be counted toward your total income.
Once you know your annual household income, refer to the 2026 Sliding Fee Schedule. Locate your family size and household income on the left of the chart. Follow that row across to the right until you find your annual household income. Whichever column you’re in will determine your slide. If you need help determining your income or your slide, our staff will be happy to assist.
Example
If you have a family size of 4 and an annual household income of $40,000, you would qualify for a B slide and an office visit would cost $70 (see below)
2026 sliding fee estimator
Estimate your sliding fee
NOTE: Enter your household size and gross income before taxes and deductions.
Your information is never submitted or saved.
$
Who counts as family? Include household members related by birth, marriage, or adoption, plus others supported by the household income.
Slide A$40At or below 100% FPL
Slide B$70101%–150% FPL
Slide C$110151%–175% FPL
Slide D$160176%–200% FPL
Slide EFull feeAbove 200% FPL
Estimate only: This calculator provides a general estimate based on Health West’s 2026 published schedule, effective January 14, 2026. It does not determine eligibility or guarantee a fee. Health West will review your application, household size, income, and documentation.