Patients may apply to Reproductive Care Associates, PC (RCA) and the Reproductive Care Center, PC (RCC) to request consideration for income based discounts. The couple will need to complete an application, submit the most recent 2 years income tax information, submit the most recent pay stubs and provide total asset information. Please FAX (801-878-8888) or mail the information to our Sandy office at 10150 S Petunia Way (10150 S 1405 E), Sandy, Utah 84092. Mail is preferred in this circumstance due to the confidential nature of this information. Please send to the attention of: Michele Richards, office administrator.
To download the application click on one of the following hyperlinks:
Income/Asset Discount Application
v3.pdf (pdf format)
General guidelines noted below. Actual discount may be less based on a combination of gross income and total assets as reflected on your application.
| |
Combined Gross Income |
% Discount |
| <$45,000 |
Free |
|
|
| |
Combined Gross Income |
% Discount |
| <$20,000 |
30% |
| $20,000-$29,999 |
25% |
| $30,000-$39,999 |
20% |
| $40,000-$49,999 |
15% |
| $50,000-$60,000 |
10% |
|
|
Discounts may be applied to self pay "fee for service" services and global fee packages. Discounts do not apply to insurance plans, diagnostic tests not performed in our office for which we would incur a fee higher than the discounted charge (in this circumstance we would offer the test at our cost) or to money back guarantee programs. |
