Good Samaritan Plan
Cooperative Health’s Sliding Fee Discount Program
Cooperative Health ensures that no patient will be denied access to health services due to their inability to pay. All patients whether insured, uninsured, or underinsured may apply. The Good Samaritan Plan can help with the cost of medical visits, lab work, procedures, and immunizations. If you need assistance with your insurance deductible, co-insurance or co-pay, this program may assist you.
Our sliding-fee program allows us to reduce and discount the fees for the care of you or your family. Eligibility is based on annual family income and household size.
Applying is easy. Applicants must:
- Be 18 years of age or older to apply
- Complete an application
- Present a valid photo ID
- Provide proof of income if age 18 or older
- Provide proof of identity for all household members (spouse and dependents) listed on the application
Download sliding fee program forms here:
Application (English)
Application (Spanish)
Acceptable Proof of Identity and Income (English)
Acceptable Proof of Identity and Income (Spanish)
Bring the completed application along with the required documents to your appointment.
Applications are also available at any Cooperative Health practice. For questions or more information, call our billing office at (803) 799-5080, option 1.
