Methods of Payment
ONE Health Ohio accepts Medicaid, Medicare, and most private/commercial health insurance plans. A sliding fee scale for the medically uninsured and underinsured is also available, based on household income and family size.
- Medicare, Medicaid, or insurance cards need to be presented at every visit so that healthcare coverage can be verified prior to being seen by the healthcare provider.
- ONE Health Ohio is NOT a free clinic. A sliding fee scale has been established to assist the medically uninsured with health care costs.
- Payment is required at the time of your visit and you will be responsible for any balances due. Financial arrangements may be made. Please check with a Front Desk Receptionist regarding payment amounts due at the time of your visit.
Sliding Fee Scale (SFS)
Uninsured patients may apply for SFS to receive discounted charges for services. The sliding fee scale may also apply to patients with insurance who have high deductibles and/or copays, as long as they qualify. SFS discount is based on total household income and number of people residing in the household. An application form must be completed and submitted for approval along with proof of household income. (Please refer to application form for acceptable proofs of income.)
Verification of SFS status is updated annually and as needed. Patients who do not supply proof of income are not eligible for SFS and are responsible for 100% of the charges incurred at the time of visit. There are no exceptions to this requirement. If qualified for the SFS, the individual will be required to pay a portion of the bill, ranging from a nominal fee to 100% of the charges at the time of visit, as follows:
- Nominal Fee= Pays only $20.00 per visit (medical) or per service (dental)
- 75%= Pays 25% of total bill per visit (medical) or per service (dental)
- 50%= Pays 50% of total bill per visit (medical) or per service (dental)
- 25%= Pays 75% of total bill per visit (medical) or per service (dental)
- 0%= Pays 100% of total bill per visit (medical) or per service (dental)
It is the patient’s responsibility to check for network coverage. Patients are responsible for 100% of the co-pay and deductible. The sliding fee scale may apply to patients with high deductibles and/or copays, as long as they qualify. If ONE Health Ohio is out of network, the patient is responsible for 100% of all costs incurred. Additionally, prescriptions, referrals, and hospitalizations may not be covered if services of a non-network provider are utilized. The responsibility of payment for any non-covered services falls upon the patient. If the insurance is major medical (hospitalization only) or does not cover a particular service (i.e., well child or dental), the patient may apply for the sliding fee scale.
Ohio Medicaid Card
- Medicaid/Healthy Start Healthy Families. Covers all services provided by ONE Health Ohio.
- All Medicaid HMO’s are accepted.
- Ohio Disability/General Assistance. Covers medical services. FOR DENTAL: it only covers tooth extractions and x-rays of the tooth to be extracted. For all other dental services, the patient is eligible for the sliding fee scale with proof of income.
- QMB/SLMB- These are not medical cards, but rather programs that help pay medical premiums.
- Family planning cards only cover family planning services.
This insurance covers those qualified 65 and older or those on SSI for medical services and flu shots. MEDICARE doesn’t cover dental services/SLMB or QI1/QI2 and QMB. However, Medicare patients may apply for the sliding fee scale for any primary dental work.
- 20% of office visit co-insurance is billable to secondary insurances if the patient has the coverage.
- Please be sure to advise us if you are enrolled in a Medicare Advantage Plan.
- QMB Medicaid for Medicare patients have no dental coverage, but Medicaid pays patient medical office visit co-pays.
- There is also coverage through Medicare Replacement Plans called Part ‘C’ plans- ex. Anthem Senior Advantage, UHC Dual Complete.
How to Pay for Services
Cash and personal checks are accepted. If a check is written it must include an imprinted name and address. Postdated checks are not acceptable. We accept most major credit and debit cards. To pay by credit card, please visit the nearest ONE Health Ohio center or contact our billing department at 330-747-9551 ext. 10606.