Paying For Your Visit

At Erie no one is ever turned away because of their ability to pay. We accept patients who have insurance and patients who do not have insurance.

Patients without Insurance

Patients without insurance are charged on a sliding fee scale, which is based on family size and household income. In order to qualify, patients must provide proof of identification, proof of family size and proof of income. This information must be renewed every 12 months.

Examples include:

  • Identification: State driver’s license, State Identification Card, Matricula Consular de Alta Seguridad (Identification card issued by the Government of Mexico), Passport, or similar identification from other countries of origin.
  • Family size: Includes any dependent children, Spouse or Partner, children attending college up to the age of 26, and any individual whom the applicant has legal responsibility for that is shown as a dependent on the taxes are also included in determining the total number of individuals in a household.

    *For children attending college you must provide a schedule or transcripts that can be utilized to verify support provided to children ages 18-26.

    Income: One months’ worth of pay check stubs and those pay check stubs of family members living with you who quality as part of the household. Other documents you can provide if you do not have any of the documents mentioned above can be found below.

Proof of Income – English
Comprobantes de ingresos – español

You may also print, read, and fill out the below application and bring it to your next appointment to see if you qualify for this program.

Sliding Fee Scale Discount Application – English
Formulario para solicitar descuento de pago basado en sus ingresos – Español

Our front desk staff will use this information to determine your fee. And if you pay on the same day as your appointment, we will provide a discount.

Note: if you have questions about your bill, call 312-666-3494 (city) or 847-666-3494 (suburbs); press 1 for Spanish or 2 for English, then press 4 and then 3 to speak to our patient billing department.