What do I need to bring to apply?

Photo ID for the head of household (any government-issued ID is fine — driver's license, passport, consular ID, Municipal ID). Proof of household income for the past 30 days (recent pay stubs, Social Security or unemployment letter, self-employment ledger, or a signed self-attestation form). Proof of household size (tax return OR a signed declaration listing dependents). If you have insurance, your insurance card. If you have no insurance, that is OK — we will help you apply for Medi-Cal, Healthy SF, or Covered California if you qualify.

Walk in to any of our five clinic locations during business hours and ask the front desk for a sliding-fee application. Or call (415) 552-3870 (Mon–Fri 8am–5pm) to be connected with an enrollment counselor. Existing patients can also bring documentation to their next appointment — we will apply the discount retroactively to that visit.

Patients

Sliding Fee Discount Program

Care for everyone — regardless of income or immigration status. We don't turn anyone away for inability to pay.

Our promise

No patient will be denied healthcare services due to an individual's inability to pay for such services. A discounted fee schedule is available based on family size and income, in accordance with Section 330 of the Public Health Service Act and 42 CFR §51c.303. Discounts apply to medical, dental, behavioral health, and other in-house services.

Discount schedule (2026 Federal Poverty Guidelines)

Effective February 16, 2026 through February 28, 2027

Your discount is based on your family size and household income as a percentage of the U.S. Department of Health & Human Services Federal Poverty Level (FPL). What you pay also depends on the type of visit — primary care, dental, optometry, podiatry, behavioral health, acupuncture, and nutrition all have their own nominal fee at each tier.

Download the full fee schedule (PDF)

MNHC sliding fee discount schedule — patient responsibility by income tier and service type, effective February 16, 2026 through February 28, 2027.
Income (% of FPL)	Primary care	Dental (preventative)	Dental (additional)	Optometry	Optical supplies	Podiatry	Acupuncture	Behavioral health	Medical nutrition therapy	Lab (in-house)
At or below 100% FPL	Pay $25	Pay $25	Pay $25 + full lab fee	Pay $25	Pay $15 + full lab fee	Pay $25	Pay $0	Pay $0	Pay $0	Pay $0
101% – 138% FPL	Pay $30	Pay $30	60% discount	Pay $30	50% discount	Pay $35	Pay $5	Pay $5	Pay $5	Pay $0
139% – 150% FPL	Pay $35	Pay $35	40% discount	Pay $35	45% discount	Pay $45	Pay $10	Pay $10	Pay $10	Pay $0
151% – 200% FPL	Pay $40	Pay $40	25% discount	Pay $40	40% discount	Pay $55	Pay $15	Pay $15	Pay $15	Pay $0
Above 200% FPL	100% of charges	100% of charges	100% of charges	100% of charges	100% of charges	100% of charges	100% of charges	100% of charges	100% of charges	100% of charges

* Nominal visit fee plus the full lab fee when lab work is needed for that visit.

Pharmacy and specialist referrals are billed separately and may not qualify for the same discount. In-house lab work is included at no extra charge at every tier; outside lab work is billed by the lab. Ask the front desk for service-specific details.

Find your income tier

Use this chart to see which discount tier your household qualifies for. Brackets are annual household income, based on the 2026 Federal Poverty Guidelines for the 48 contiguous states.

Annual household income range by family size at each Federal Poverty Level discount tier.
Family size	At or below 100% FPL	101% – 138% FPL	139% – 150% FPL	151% – 200% FPL
1	Up to $15,960	$15,961 – $22,025	$22,026 – $23,940	$23,941 – $31,920
2	Up to $27,050	$27,051 – $37,329	$37,330 – $40,575	$40,576 – $54,100
3	Up to $34,150	$34,151 – $47,127	$47,128 – $51,225	$51,226 – $68,300
4	Up to $41,250	$41,251 – $56,925	$56,926 – $61,875	$61,876 – $82,500
5	Up to $48,350	$48,351 – $66,723	$66,724 – $72,525	$72,526 – $96,700
6	Up to $55,450	$55,451 – $76,521	$76,522 – $83,175	$83,176 – $110,900
7	Up to $62,550	$62,551 – $86,319	$86,320 – $93,825	$93,826 – $125,100
8	Up to $69,650	$69,651 – $96,117	$96,118 – $104,475	$104,476 – $139,300
9	Up to $76,750	$76,751 – $105,915	$105,916 – $115,125	$115,126 – $153,500
10	Up to $83,850	$83,851 – $115,713	$115,714 – $125,775	$125,776 – $167,700

For households larger than 10, call (415) 552-3870 or ask at the front desk — the chart extends with an added amount per person at each tier.

Who qualifies

Every patient — insured or uninsured, documented or undocumented, employed or not — is invited to apply. Eligibility is based only on family size and household income, not on immigration status, social security number, or proof of address.

Open to all MNHC patients across all five clinic sites.
Recertification is required once a year, or sooner if your income changes.
If you cannot provide income documentation, you may complete a self-attestation form.
Patients who refuse to provide income information are charged the standard fee.

What to bring to apply

Photo ID for the head of household (any government-issued ID is fine — driver's license, passport, consular ID, Municipal ID).
Proof of household income for the past 30 days (recent pay stubs, Social Security or unemployment letter, self-employment ledger, or a signed self-attestation form).
Proof of household size (tax return OR a signed declaration listing dependents).
If you have insurance, your insurance card. If you have no insurance, that is OK — we will help you apply for Medi-Cal, Healthy SF, or Covered California if you qualify.

Bilingual English/Spanish enrollment counselors are available at every clinic to walk through the form with you. The application takes about 15 minutes.

How to apply

Walk in to any of our five clinic locations during business hours and ask the front desk for a sliding-fee application.
Or call (415) 552-3870 (Mon–Fri 8am–5pm) to be connected with an enrollment counselor.
Existing patients can also bring documentation to their next appointment — we will apply the discount retroactively to that visit.

Your rights

MNHC will not deny services, refuse to schedule appointments, or otherwise discriminate based on your enrollment in the Sliding Fee Discount Program, your ability to pay, your insurance status, or your immigration status. If you believe you have been treated unfairly, you may file a complaint at no risk of retaliation with our compliance officer (compliance@mnhc.org · (415) 552-3870 ext. 2284) or with HRSA at hrsa.gov/about/contact.