WFHC Fl

  • Fort Pierce | 772-468-9900
  • Vero Beach | 772-257-5785
wfhc

Insurance Accepted

Insurance & Payment

As a federally designated provider of services for individuals with limited access to care and limited resources, WFHC accepts most insurances and offers a sliding fee discount program. No one is turned away for their lack of ability to pay. All patients are informed of the sliding fee discount and requested to complete the application and provide income documentation at their first appointment.

Insurance

We participate with Medicare, Medicaid, and most commercial insurance plans. To determine if we participate with your insurance plan, please call your insurance company, or look in your participating network guide prior to your visit. If you provide complete and accurate information about your insurance, we will submit claims to your insurance carrier and receive payment for services. However, depending on your insurance coverage, you may be responsible for co-payments, co-insurance, or deductible amounts. You are responsible for paying those charges.

WFHC accepts the following insurances:

Medicaid

  • Aetna Better Health of Florida – Florida Healthy Kids
  • Beacon Health Options (Behavioral Health Only)
  • Simply Healthcare
  • Community Care Plan – Florida Healthy Kids
  • ChampVA
  • Coventry
  • Evercare
  • Freedom Health (Infectious Disease Only)
  • Humana
  • Medicaid
  • Miami Children’s Health Plan
  • Optum Behavioral Health Solution
  • Prestige
  • Secure Horizons
  • Simply Healthcare
  • Staywell AKA WellCare
  • WellCare of Florida – Children’s Medical Services Health Plan
  • Sunshine Health
  • United HealthCare

Medicare

  • Aetna
  • Florida Blue (BCBS)
  • Care Plus (Indian River County)
  • Clear Health Alliance
  • Health First (Indian River County)
  • Humana
  • Medicare
  • Molina
  • WellCare
  • Sunshine Health

Commercial Insurance

  • Aetna
  • Allied Indemnity Plan
  • Ambetter Sunshine
  • Florida Blue (BCBS), MyBlue and SimplyBlue Plans not included)
  • Cigna
  • Community Care Plan
  • Coventry
  • Emblem Health – GHI
  • First Health (Under Aetna’s Umbrella)
  • Health First (Indian River County)
  • Humana
  • Tricare
  • United HealthCare

 

Sliding Fee Discount Program

Worried that you can’t afford health care services? No Insurance?

We can help! WFHC offers services to all patients regardless of their ability to pay. Discounts are offered based on family size and income. The WFHC Sliding Fee Discount Program covers payment for necessary medical and behavioral health services. It also may cover medications purchased through the WFHC onsite pharmacies. This program helps to reduce and/or eliminate financial barriers to care for medically underserved populations in our community.

WFHC maintains a standard procedure for qualifying patients for sliding fee discounts for services provided. Sliding fee discounts are available to patients with all incomes at or below 200% of the federal poverty guidelines.

How Do I Qualify?
Like every program, WFHC Sliding Fee Discount Program has requirements. The federal government requires that we obtain specific information from our patients prior to determining eligibility and establishing a sliding fee level. You must fill out an application and provide proof of income. Forms can be found at the clinics, on our website or by speaking to a WFHC team member at 1-877-345-9342. Determinations are not made until the required documentation has been provided.

What if I have insurance?
Even if you have insurance, you may still qualify for our sliding fee discount program. We will process your insurance claim first, and then any remaining balance may be adjusted based on the sliding fee scale.

Do I have to provide financial information?
In order to determine your eligibility for the sliding fee discount, and what you’ll pay, we will need proof of income and your household size. Proof of income can be determined easily with: Paycheck stubs, current year tax returns for self-employed individuals and with other items.

How do you determine household size?
Anyone living in the household, where a legal financial responsibility for support exists, is considered a household member.

How often do I need to apply?
You will need to apply annually or if there is a change in household or income status.

All applicants need to furnish the following documentation at the time of the appointment:

Proof of Residency Two approved documents for proof of residency must have a date less than or equal to six months, except for when using a valid Florida driver’s license. (P.O. Boxes cannot be used for proof of residency)
Identification One photo ID or two forms of verified identification
Household Income 4 weeks (most recent) pay stubs

If you have any further questions regarding the Sliding Fee Discount Application, please speak to a WFHC team member today at 877-345-9342.

Indian River County Hospital District Funding

IRCHD helps ensure that essential health care services are provided to the underserved by reimbursing not-for-profit organizations for the care they deliver to individual patients. WFHC has partnered with IRCHD to offer primary care and behavioral health services to uninsured or underinsured residents of Indian River County. Eligibility is determined based on household size and income. For more information please speak to an WFHC team member today at 877-345-9342.

IRCHD Financial Assistance Application

We accept any of the following as proof of income for the Sliding Fee Discount Program and the Indian River County Hospital District Funding:

The following are considered as income sources for the purposes of determining/verifying eligibility:

  • Wages, salaries and gratuities
  • Social Security Benefits
  • Supplemental Social Security and Disability Benefits
  • Retirement and Pension Benefits
  • Royalties and Rents
  • Unemployment and Worker’s Compensation
  • Veterans and Military Allotments
  • Strike Benefits
  • Insurance and Annuity Income
  • Dividends and Interest Earnings unless counted as an asset
  • Estate and Trust Fund Income
  • Private loans of a recurring nature
  • If an applicant's self-declared income is less than $900/month a Letter of Support is required or an acceptable, documentable explanation of how the applicant is meeting expenses.

The following are some examples of Self-employment:

  • Baby sitting
  • Lawn service
  • Car detailing
  • Selling newspapers
  • Any other work or service performed by the person in which there is no formal employer/employee relationship.

For information on how to upload your documents directly onto the patient portal, click here.

Athena Patient Portal Secure Messaging

 

Payment Options

Whole Family Health Center accepts Medicare, Medicaid and most commercial insurances. We accept self-pay patients and offer a sliding fee discount program for eligible patients based on household income and family size. If your insurance requires a co-payment, we expect to collect that at the time of service.

For payments made on the same day as the visit, a 50% discount will be offered. This discount applies to copays, coinsurances, and sliding fees. If you cannot pay at the time of service, payment plans are available. To make a payment on your account, contact a WFHC team member at 877-345-9342.

Appointments

First-time patient at Whole Family Health Center?

Please also have the following with you when you arrive:

  1. Photo ID
  2. Uninsured patients, please provide 4 weeks of income verification (pay stub, W2, or tax return)
  3. Undocumented and uninsured patients must provide a Letter of Support
  4. Insurance Card (if applicable)
  5. Past Medical Records (if applicable)

For Existing Whole Family Health Center patients:

To access your records, email your provider and more, use our Patient Portal with your Athena Patient Login information.