Sliding Scale
Hope Seed offers a sliding scale fee for those who cannot afford the full fee. The sliding scale is designed to help those without out-of-network coverage or high insurance deductibles. The scale is based on availability and financial need.
How Do I Know If I am Eligible?
To be eligible for the sliding scale, you must apply and provide income information and an explanation of why you are not able to pay the fee in full. Hope Seed requires that you fill out the application below and verify your income with a paystub or financial statement. After the sliding scale verification is processed, an appointment can be scheduled. Please allow 72 hours to process. If you have not heard back from us by then, please call 832-257-3778 to ensure we received your submission. Thank you
To understand Good Faith Estimate: Please see the button at the bottom of our webpage.
How Long Can I Receive A Sliding Scale Rate?
Hope Seed’s sliding scale rates are approved for a duration of 3 months at a time. If during the 3 months your financial situation changes, please let our office know at 832-257-3778.
After your rate expires, you will default back to the full fee unless you re-apply for a sliding scale and are approved. Generally, the limit for a sliding scale rate is one year unless extenuating circumstances exist.
For this reason, we ask that you consider the sliding scale a benefit that is intended to help you during a time of financial need while facing Mental Health issues rather than a permanent fee for service.
Please Fill Out Application Below
Financial Verification
Please submit it with one of the six verifications for financial assistance. Our organization offers sliding scale counseling fees based on income or financial need.
1. Copy of your most recent Tax Return
2. Copy of Social Security Benefits or Disability Check (if receiving)
3. Copy of two of your most recent paystubs for each person working within your home.
4. Copy of recent Welfare Benefits, TANIF, Food Stamps, Section 8 Housing Letter (if applicable)
5. Copy of Unemployment Benefits Statement or Paycheck Protection Program (if applicable)
6. If No Income verification: please have a letter notarized from the person(s) who provides your monthly living expenses or rent.
Please contact the IRS for a copy if you do not have your tax return. If you did not file taxes this year and can not verify any other documents on this list, please submit a letter to Hope Seed Support Center explaining your personal situation by email.
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