Does my Financial Assistance expire? How will I know it is time to reapply? Yes. Your financial assistance benefit will expire. Your individual financial assistance ID card will indicate the expiration date on the bottom left corner. One month prior to the expiration date indicated on your ID card, you need to reapply by submitting a new application form and provide all the required documentation indicated on the form. This will allow our Customer Service team to review and prepare your application for approval. Eligibility Requirements 100% 75% 50% 25% 2015 Discount Discount Discount Discount Federal 250% of 300% of 350% of 400% of Poverty Federal Federal Federal Federal Guideline Poverty Poverty Poverty Poverty (FPG) Family Size Period Guidelines Guidelines Guidelines Guidelines 1 Annual $29,425 $35,310 $41,195 $47,080 $11,770 2 Annual $39,825 $47,790 $55,755 $63,720 $15,930 3 Annual $50,225 $60,270 $70,315 $80,360 $20,090 4 Annual $60,625 $72,750 $84,875 $97,000 $24,250 5 Annual $71,025 $85,230 $99,435 $113,640 $28,410 6 Annual $81,425 $97,710 $113,995 $130,280 $32,570 7 Annual $91,825 $110,190 $128,555 $146,920 $36,730 8 Annual $102,225 $122,670 $143,115 $163,560 $40,890 Each Add'l Person Annual $4,160 If I have additional questions, who can I call? Customer Service colleagues are available to answer any questions from Monday through Friday 8:00 am to 4:00 pm at 215-710-6500. St. Mary Community Ministries Resources for Uninsured & Underinsured Patients Mother Bachmann Maternity Center 215.245.4334 St. Mary Health Center 215.245.8873 Children’s St. Mary Family Resource Center 215.245.8563 BCHIP Adult Health Clinic 215.633.8652
Does my Financial Assistance expire? How will I know it is time to reapply? Yes. Your financial assistance benefit will expire. Your individual financial assistance ID card will indicate the expiration date on the bottom left corner. One month prior to the expiration date indicated on your ID card, you need to reapply by submitting a new application form and provide all the required documentation indicated on the form. This will allow our Customer Service team to review and prepare your application for approval. Eligibility Requirements Family Size Period 100% Discount 250% of Federal Poverty Guidelines 50% Discount 350% of Federal Poverty Guidelines 25% Discount 400% of Federal Poverty Guidelines 75% Discount 300% of Federal Poverty Guidelines 2015 Federal Poverty Guideline (FPG) 1 Annual $29,425 $35,310 $41,195 $47,080 $11,770 2 Annual $39,825 $47,790 $55,755 $63,720 $15,930 3 Annual $50,225 $60,270 $70,315 $80,360 $20,090 4 Annual $60,625 $72,750 $84,875 $97,000 $24,250 5 Annual $71,025 $85,230 $99,435 $113,640 $28,410 6 Annual $81,425 $97,710 $113,995 $130,280 $32,570 7 Annual $91,825 $110,190 $128,555 $146,920 $36,730 8 Annual $102,225 $122,670 $143,115 $163,560 $40,890 Each Add'l Person Annual $4,160 If I have additional questions, who can I call? Customer Service colleagues are available to answer any questions from Monday through Friday 8:00 am to 4:00 pm at 215-710-6500. St. Mary Community Ministries Resources for Uninsured & Underinsured Patients Mother Bachmann Maternity Center 215.245.4334 St. Mary Children’s Health Center 215.245.8873 St. Mary Family Resource Center 215.245.8563 BCHIP Adult Health Clinic 215.633.8652
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