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Skip Navigation LinksHarris Health Access Care Eligibility Calculator - Assistance Plan Three

Eligibility Calculator - Assistance Plan Three

​All patients* are asked to make a minimum payment at the time of their hospital or clinic visit, except for pediatric and prenatal care visits.

The following service fees must be paid at the time you receive service and are for Harris Health System services only. Remaining balances will be billed to you.

You will receive a separate bill for doctor charges. However, you may be asked to pay a physician down payment in addition to the amounts listed below.

Medicare prescription co-pays are charged according to your plan requirements. Fees for dentures apply to all patients regardless of patient class and are based on a fee schedule established by Dental Services.

Please go to our Web site at www.harrishealth.org for more details on patient eligibility and service fees.

Service Fee Schedule  Deposit
Clinic (1) $38
Dental (2) $38
Per Prescription $20 for each 30-day prescription for medicines costing $200 or less per month
10% of the total price for medicines costing more than $200 per month
$10 for medicines on the 90-day list
Emergency Room Visit $100
Day Surgery $1,000
Inpatient Stay $1,000


Special Notes:
* Service fees do not apply to patients in the HealthCare for the Homeless Program.
(1) Due each time you visit the clinic, even when you do not see the doctor.
(2) Dentures must be paid per Dental Service charges.

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