Applying for the Sliding Fee Scale Discount

In order to remain in compliance with federal regulations, Lyon-Martin will begin requiring more information from patients applying for the sliding fee scale discount as of March 13, 2013. To qualify for the sliding fee scale your household income must be at or below 200% of the federal poverty level*, based on household size, and you must be un/underinsured.  Household members include those persons living in the same home who are related by birth, marriage, registered domestic partnership or adoption.  For more information call reception at 415-565-7667. To apply for the sliding fee scale:

1.  Make an appointment with a certified application assister at Lyon-Martin

2.  Fill out our application.

3.  Bring in proof of identity issued by a government or institution (i.e. university), for example:

  • Drivers license
  • Passport
  • State/city ID
  • Permanent Resident Card
  • Student ID

4.  Bring in proof of household income for all adult household members, for example:

  • Most recent pay stub
  • Most recent tax return
  • Unemployment benefits check stub or original award letter

Already a patient with us?

  • If you told us your income was at or below 200% of the federal poverty level, we will honor your “self-attestation” until your next birthday and you will be eligible for the sliding fee scale discount.
  • If you told us that your incomes was above 200% of the federal poverty level, you will no longer be eligible for the discount and will be charged full fee at your next visit.  However, if your income has decreased or your household size has increased, you may reapply at any time.

Federal Poverty Line Guidelines 2016

Other discounts are available and if you are unable to pay the amount due at the time of service, you can speak with our Comprehensive Patient Service Associates (CPSA) to work out a payment plan that will help you resolve outstanding bills. And we remain committed to our mission — no patient will be turned away for inability to pay.