Financial Assistance Program

What does the Financial Assistance Program Cover?

The Financial Assistance Card allows patients to receive a discount on services provided by Lamprey Health Care. The Financial Assistance Card only covers services offered by Lamprey Health Care and is NOT an insurance card.

Patients requiring labs, or other diagnostic services at other facilities need to apply for financial assistance at those organizations. Our Care Coordinators can assist you in determining which facilities in our area also offer financial assistance programs.

Applying for Financial Assistance

To be eligible for this program, patients must meet certain income guidelines. For information on the Financial Assistance Program, ask to speak with a Certified Application Counselor.

2022 Sliding Fee Scale Grid as of March 1, 2022

To apply for the program, please complete the following form and follow the instructions to return the application.

English, Sliding Fee Discount Program Instructions & Application
Spanish, Sliding Fee Discount Program Instructions & Application
Portuguese, Sliding Fee Discount Program Instructions & Application

What will I have to pay?

Until the Financial Assistance application and necessary documents are received, you will be expected to pay the full fee for your visits and related care.

If you qualify, you will be issued a Financial Assistance Card, which will clearly state your level of discount. Discount ranges fall into four categories. You must bring this card to your visit so your discount can be applied.

All discount ranges within the program include a nominal fee to be paid by the patient. This fee will be collected at the time of the visit. The Financial Assistance Card covers services provided through our prenatal program as well.

What if I can’t pay?

All fees are expected at the time of each visit. If you are unable to pay for services at the time of the visit, you will be sent a bill for any unpaid balance.

We also offer payment plans to patients who are unable to pay their balance. You can speak with a Patient Service Representative at the health center, or you may contact our billing office by selecting option six on our telephone menu.

Health Care Marketplace

Marketplace Re-opens! 

Due to the pandemic, the federal government has declared a Special Enrollment Period (SEP) that re-opens the Affordable Care Act (ACA) marketplace from February 15 – August 15, 2021. This means individuals who need to change or enroll for health insurance can do so until the deadline.

If you or someone you know has been affected by the pandemic and lost your insurance, call our office to speak with our Certified Application Counselor. They are standing by to help you navigate to find the best insurance fit for your healthcare needs.

What is the Health Care Marketplace?

The Health Care Marketplace helps uninsured people find health coverage. Plans cover essential health benefits, pre-existing conditions, and preventive care. Costs depend on your household income. You might qualify for lower costs based on your household size and income. You may also be eligible for Medicaid. If you don’t qualify for lower costs, you can still use the Marketplace to buy insurance.

How do I enroll?

Open enrollment for health coverage will take place in the fall of 2021. Stay tuned for exact dates when released. You can enroll outside of the open enrollment period if you have had a qualifying life event.

You can apply for health coverage:

  • Online
  • By Phone
  • With in-person help
  • Through an agent or broker
  • With a paper application

If you’re eligible for job-based insurance, you can still switch to a Marketplace plan. In this case, you won’t qualify for lower costs. The only exceptions are if the job-based insurance is unaffordable or doesn’t meet minimum requirements. You may also lose any contribution your employer makes to your premiums.

Oh, No! I Missed Open Enrollment.

You may qualify for health coverage if you have specific life changes. Life changes include moving to a new state, marriage, childbirth, or loss of coverage.

I need help.

Our Certified Application Counselors can help you understand your options. They can also assist with the application process. There is no cost for this service. Simply ask to speak with a Certified Application Counselor.

You can also visit or call the Marketplace Call Center at 1-800-318-2596. TTY users can call 1-855-889-4325.


Medicaid will accept applications throughout the year.

Low-income NH residents may be eligible for low or no-cost health coverage through Medicaid. Documentation is required to confirm eligibility.

Our Certified Application Counselors can help you determine if you qualify for NH Medicaid. They can also assist with the application process. To apply online, visit

The NH Medicaid Service Center can also assist you with questions. Call 888-901-4999, Monday through Friday from 8:00 am to 4:00 pm.


Open Enrollment: Fall 2020

Open enrollment for Medicare is the only time of year that you can switch your Part D plan or Medicare Advantage Program.

Information on Medicare Open Enrollment is available by contacting the Social Security Office at (800) 772-1213 (TTY users 1-800-0778). They are open Monday through Friday, from 7 am to 7 pm.

You can also contact Service Link for assistance with Medicare Open Enrollment.

Medication Assistance

If you need help paying for medications to treat a chronic condition, you may qualify for medication assistance. The pharmaceutical industry offers many different programs.

Our staff can determine if you are eligible and help you with the application process. It can take up to four to six weeks to enroll. Renewal applications are required every three months. There is a $3.00 fee for each application.

Please ask to speak with the Prescription Assistance Coordinator for more information.

PLEASE NOTE: When refills are needed, contact the Prescription Assistance Coordinator. Allow for several weeks to avoid interruptions in your medication therapy.