CHARITY CARE CALCULATION:

(Orleans Community Health Financial Counseling staff will do calculations using a Spreadsheet tool to determine patient responsibility)

To calculate a patient’s allowance under Orleans Community Health’s Charity Care policy for qualifying individuals, annual household income is to be divided by the applicable 100% (first column) Federal poverty guideline below for the patient’s family size to arrive at income as a percentage of the poverty guideline. A percentage of the qualifying patient’s charges will be discounted off as indicated by one of the six ranges below. The remaining balance represents the patient’s payment responsibility.

 

2022 Federal Poverty Level

Family

Size

100% Guideline*150% Guideline200% Guideline250% Guideline300% Guideline400% Guideline
1$13,590.00$20,385.00$27,180.00$33,975.00$40,770.00$54,360.00
2$18,310.00$27,465.00$36,620.00$45,775.00$54,930.00$73,240.00
3$23,030.00$34,545.00$46,060.00$57,575.00$69,090.00$92,120.00
4$27,750.00$41,625.00$55,500.00$69,375.00$83,250.00$111,000.00
5$32,470.00$48,705.00$64,940.00$81,175.00$97,410.00$129,880.00
6$37,190.00$55,785.00$74,380.00$92,975.00$111,570.00$148,760.00
7$41,910.00$62,865.00$83,820.00$104,775.00$125,730.00$167,640.00
8$46,630.00$69,945.00$93,260.00$116,575.00$139,890.00$186,520.00