Eligibility & Payment

Eligibility & Payment

There are no restrictions or eligibility requirements to receive care at Lone Star Circle of Care. As a Federally Qualified Health Center, we provide care to anyone, regardless of income, residency status, employment, health insurance coverage, or ability to pay for services. You do not have to be a resident of any specific city, county, or area to access our services.

Lone Star Circle of Care does not discriminate on the basis of race, color, national origin (including limited English proficiency), religion, disability, age, or gender. To view our Statement on Non-discrimination, please click here.

Payment for Services

Lone Star Circle of Care accepts Medicaid, Medicare, CHIP, MAP, Wilco, Texas Children’s and most insurance plans. Click here for a list of insurance plans Lone Star Circle of Care accepts.

For our uninsured and underserved patients, we will make every effort to make your health care more affordable. Before your first appointment, you will meet with a Program Adviser and participate in a simple income screening process. This Program Registration process will determine if you or a member of your family may be eligible for our Sliding Fee Discount Program as well as other public assistance health care programs. Our staff will also help you apply to these assistance programs. No patient is ever denied services based on an inability to pay.

Right to Receive a “Good Faith Estimate”

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate that explains how much their medical care will cost.

  • You have the right to receive a Good Faith Estimate (“GFE”). The GFE is for the total expected cost of any routine (non-emergency) items or services. This includes related costs like tests, prescription drugs, equipment, and usual fees.
  • Your health care provider should give you a GFE in writing at least 1 business day before your medical service or visit. You can also ask any of your health care providers for a GFE before you schedule a visit or service.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
  • Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

Derecho a recibir una “estimación de buena fe”

Según la ley, los proveedores de atención médica deben proporcionar a los pacientes que no tienen seguro, o que no usan seguro, una estimación que explique cuánto costará su atención médica.

  • Usted tiene derecho a recibir una estimación de buena fe (Good Faith Estimate o GFE, por sus siglas en inglés). El GFE es por el costo total esperado de cualquier artículo o servicio de rutina (que no sea de emergencia). Esto incluye costos relacionados con sus cuidados como exámenes médicos, medicamentos recetados, equipo y tarifas hospitalarias.
  • Su proveedor de atención médica debe darle una GFE por escrito al menos 1 día hábil antes de su visita o servicio médico. También puede pedirle a cualquiera de sus proveedores de atención médica un GFE antes de programar una visita o servicio.
  • Si recibe una factura por un valor de al menos $400 más que su “estimación de buena fe”, podrá disputar la factura.
  • Asegúrese de guardar una copia o una foto de su “estimación de buena fe”.

Si tiene preguntas o desea más información sobre su derecho de obtener una estimación de buena fe, visite www.cms.gov/nosurprises.

Sliding Fee Discount Program

If you do not qualify for health care coverage or your insurance does not cover certain types of services, Lone Star Circle of Care offers discounted services according to a sliding fee scale based on your income and family size.

Our sliding fee scale works by providing lower income patients and families with larger discounts based on Federal Poverty Level (FPL) guidelines. The table below outlines LSCC’s Level 1-5 plans based on FPL. Levels 1 through 4 will receive a discount on services, with Level 1 patients receiving the largest discount. Level 5 designated patients (over 200% of FPL) will be required to pay 100% of charges.

Percentage of Federal Poverty Level (FPL) Guidelines LSCC Plan Level
0 to 100% FPL Level 1
101 to 133% FPL Level 2
134 to 150% FPL Level 3
151 to 200% FPL Level 4
Over 200% FPL Level 5

If you have questions regarding the Sliding Fee Discount Program or screening process, please contact Lone Star Circle of Care’s Patient Services department at 512-686-0534.