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Insurance Assistance

CareSTL Health’s Outreach Department employs Eligibility Enrollment Specialists who are trained Certified Application Counselors at our four locations to educate and enroll patients in a health insurance plan including Medicaid, Medicare, Gateway to Better Health and the Affordable Care Act.  Our enrollment specialists educate patients about available health insurance plans that will accommodate the individual’s healthcare and financial needs.

Eligibility Specialists are also available to provide health insurance education and enrollment at events in the community. Walk-ins are welcomed and encouraged. Patients can also schedule an appointment by calling the nearest location and asking for the Outreach Department.  For more information please call our appointment line at 314-633-6363.

Income Based

CareSTL offers a sliding fee program to help reduce barriers to access to healthcare services for our patients. The sliding fee scale applies to patients without health insurance who also do not qualify for Medicaid. The sliding fee scale is based on household size and the poverty guidelines set by the U.S. Department of Health and Human Services. Patients are required to meet the income eligibility by submitting one or a combination of the following for proof of household income:

  • Two or more of your most recent check stubs for all members of the household
  • A letter from employer stating annual income
  • W-2 forms for all family members for the previous year
  • Federal Tax return from the previous year
  • Social security/entitlement statement from previous month
  • Letter from Division of Employment Security

 Click here for the Sliding Fee Scale 2019.

The annual income for the household must be calculated and documented in order to receive a discount as mandated by federal rules governing Federally Qualified Health Centers. Patients must complete paperwork provided by Registration Services before being seen under the sliding fee program. For additional information contact Registration Services at the site nearest you.

Acceptable Forms of Proof of Income:

  • State-issued identification or passport
  • Proof of residency
  • Last TWO consecutive paycheck stubs
  • Most recent unemployment compensation letter showing full weekly benefits
  • Current award letter for everyone in the household receiving Social Security disability, retirement, survivor benefits and/or SSI

Our social workers can help manage your conditions and treatments by working with your primary care provider. They can also offer counseling support and can help connect you with the resources you may need. To work with a social worker, please give us a call at any one of our four locations!

MO Health Net

Some private insurance plans are accepted. Charges for patients without insurance are calculated on a sliding fee scale depending on income and family size. Medication discounts are available for all eligible patients.

Eligibility Requirements

  • U.S. Citizen of eligible legal immigrant
  • Missouri resident = Must have a valid social security card
  • Must meet household/income guidelines
  • Age: Birth to 18
  • Age: 19 – 64 (receiving TANF benefits)

Coverage Benefits

  • Primary and preventive medical visits
  • Dental services for children
  • Eye exams – every two years
  • Women’s Health services – Family planning, prenatal visits, and delivery services
  • Behavioral health and substance abuse

Gateway to Better Health

Gateway to Better Health is a temporary health care program for uninsured adults in St. Louis City and County. The program is designed to provide uninsured adults a bridge in care until they are able to enroll in health insurance coverage options available through the Affordable Care Act.

Who is eligible for Gateway to Better Health:

  • Adults between the ages of 19-64
  • Are not eligible for MO HealthNet (Medicaid) or Medicare
  • Are patients at one of the participating health centers
  • Have no other insurance
  • Have income at or below 100% of the federal poverty level ($12,140 per year for an adult living alone or $25,100 per year for a family of four)
  • Live in St. Louis City or County

What are the benefits? Gateway to Better Health covers:

  • Primary Care Services
    • Preventative Dental
    • Eye Exams
    • Podiatry
  • Specialty Care Services
  • Urgent Care Services (up to 5 visits)
  • Limited Outpatient Hospital Services
  • Generic prescriptions and brand name insulin and inhalers dispensed by the patient’s primary care home
  • Non-emergency medical transportation

There are no premiums for the program. Co-pays for Gateway to Better Health are $0.50 – $10.00. Please call the Gateway to Better Health Call Center at 1.888.513.1417 for additional information on program benefits.

Documents you may need to apply:

  • Proof of citizenship or visa status. To show you are a legal citizen of the United States or in the United States legally.
  • Proof of income. Proof of your income for the last 30 days. (For example, if you are paid weekly, you will need to provide four of your most recent pay stubs.)

People born in Missouri do not need to provide all documents. Please check with your health center for more information on what you will need to submit.

All applications will be screened to see if you are eligible for MO HealthNet coverage. Remember, only adults who are uninsured or are not eligible for MO HealthNet will get Gateway to Better Health.

Healthcare.gov

Eligibility Requirements

  • U.S. citizen or eligible legal immigrant
  • Missouri resident (valid social security card)
  • Adults (up to age 64)
  • Children (birth – age 18 if not on Medicaid )
  • Adult Children (up to age 26 if on parent’s coverage)
  • Individual ($15,282 per year income level)
  • Family of 4 ($31,322 per year income level)

 

Coverage Benefits – Mandatory 10 Essential Benefits

  • Ambulatory services
  • Emergency services
  • Hospitalization
  • Laboratory services
  • Maternity and newborn
  • Mental health and substance use disorder services
  • Prescription drugs
  • Rehabilitative and habilitative services
  • Preventive and wellness services
  • Pediatric services including oral and vision care

Comprehensive

We eliminate barriers and offer a centralized, holistic approach to care.

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