Upham’s Corner Health Center (UCHC) is a Federally Qualified Health Center (FQHC) and accepts all patients, regardless of their insurance status or ability to pay.

UCHC encourages patients without health insurance or with limited health insurance coverage to apply for government-sponsored coverage (such as MassHealth or Health Safety Net) through the Enrollment Department located at 415 Columbia Road.  If you are not eligible for one of these programs, decide not to apply, or other circumstances exist, UCHC maintains a Sliding Fee Discount Program to minimize financial barriers to care.

We offer the Sliding Fee Discount Program to all income-eligible uninsured or underinsured patients, based on family size* and income*, for most health center services.  In order to determine eligibility in a uniform manner, we require patients to complete a Sliding Fee Discount Program Application and to provide documentation of stated income.  What we mean by “income” and “family size”, and examples of acceptable documentation for the verification of income for the Sliding Fee Discount Program Application are listed below.

 

Definition of Income

Earnings over a given period of time used to support an individual/household unit based on a set of criteria of inclusions and exclusions. Income includes gross wages’; salaries; tips; income from business & self-employment; unemployment compensation; workers’ compensation; Social Security; Supplemental Security Income;  veterans’ payments; survivor benefits; pension or retirement income; interest; dividends;  royalties, income from rental properties, estates& trusts; alimony; child support; assistance from outside the household; and other miscellaneous sources. Noncash benefits (such as food stamps and housing subsidies) do not count.

Applicants should provide a copy of any income verification materials that apply to them.  A few examples are listed below.

 

Examples of Acceptable Income Verification

  • Two (2) consecutive pay stubs for each employed adult age 18 and over living in the household, or living outside the household but for whom the household is financially responsible.
  • Previous year’s tax return or W-2 for each adult living in the household or for whom the household is financially responsible (income will come from gross income line on respective tax return).
  • Letter from employer.

 

Definition of Family Size

Either an individual (with a family size of “1”); or a group of two people or more (one of whom is the householder) related by birth, marriage, or adoption and residing together; all such people (including related subfamily members) are considered as members of one family.

 

How to Apply for the Sliding Fee Discount Program

For those who want to apply for the Sliding Fee Discount Program, you will need to visit the UCHC Registration Department located on the first floor of our 415 Columbia Road location. The Registration staff will assist you in completing the application and determining your eligibility.  Please remember to bring the above income verification documentation with you to the Registration Department.

If you would like to review [or complete] the UCHC Sliding Fee Discount Application before coming to UCHC, you may download it using the link below. There is no way to submit it online; so, if you would like to complete it beforehand, please print it and bring it with you.

 

As an FQHC, UCHC accepts all Medicare and Medicaid insurance plans, as well as most major insurances. The Sliding Fee Scale Discount Program is in place to meet the needs of the uninsured or underinsured, providing reduced costs on most services for those who qualify.

No one will be denied access to health center services at UCHC, as services are offered regardless of insurance status or ability to pay.

Registration Department

415 Columbia Road
First Floor
Dorchester, MA 02125

617-287-8000

Hours

Monday – Thursday:  8:00 am to 8:00 pm

Friday:  10:00 am to 4:30 pm

Saturday:  9:00 am to 12:00 pm

Please click on the Sliding Fee Discount Application Form images below. You may download and print this form to use.

Sliding fee discount application form
Sliding fee discount application form for office use only