Sliding Fee Discount Program
Whether or not you have health insurance, Terry Reilly Health Services may be able to reduce your costs through our Sliding-Fee Discount Program. People at or under 200% of Federal Poverty Guidelines are typically eligible. Once approved for a discount, the amount you pay is based on family size and verified income.
Household size is the number of immediate family members including the applicant who are at least 50% dependent upon the income being reported on the application. Typically, this is you, your spouse and your children.
How to Apply
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Complete the application
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Gather required forms of income verification
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Submit completed application and required verification forms
Our front desk staff and patient navigators are always available to help you through this process.
Phone: (208) 318-1326
Email: PatientNav@TRHS.org
Application
Forms available at front desk of any Terry Reilly location or print here:
Advisory: Application becomes void if income verification is not supplied within 30 days of signing. Patient will be charged full fees until a new form is completed and income eligibility is determined.
Accepted Forms of Verified Income
Income type
If you are employed:
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paystubs issued from all employers within the last 30 days
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or a tax return filed within last 90 days
If you are self-employed:
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tax return filed within the last 90 days
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or a current bank statement showing 90 days of income
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a profit & loss statement for the previous 12 months
If you are paid in cash:
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a bank statement with 90 days of history
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AND a SIGNED and DATED letter from your employer listing:
-your name
-employer’s name
-initial date of employment
-rate of pay and frequency
If you collect unemployment or workman’s compensation:
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bank statement with 30 days of history
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or official notification stating amount of benefit and weeks remaining
Do you receive other assistance such as?
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Worker’s Compensation
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Social Security
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Supplemental Income (SSI)
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Pension/retirement
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Rental property income
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Trust or estate funds
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Child Support
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Alimony
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Veteran’s benefit
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Survivor’s benefit
You will need
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Bank statement with 30 days of history
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or current determination letter/benefit summary
If you have no household income:
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Further verification is required
How to Submit
In Person: Return completed application and required verification forms at any Terry Reilly location.
By Mail: 211 16th Ave. North, Nampa ID 83653-0009 (Please mail document copies only. Originals will not be returned)
Frequently Asked Questions
How long is my discount effective?
Sliding-Fee discounts are effective for 12 months. If financial assistance is still needed after a year, patients will need to re-apply.
Does the sliding-fee apply to my prescription at Terry Reilly?
Yes, your prescription co-pays might be affected so it is important to complete your sliding-fee application prior to filling a prescription or you may lose discounts on your medication.
Is Terry Reilly’s sliding-fee discount valid at other healthcare providers?
No. Our sliding-fee discounts are only valid for services and prescriptions delivered at Terry Reilly.
What if my information changes?
If your application is approved, you must report any changes of income, address, and/or contact information within 10 days of the change to Terry Reilly patient financial services.