Annual Updating For Discount Services

In order to receive discounted services, all patients must file an agreement for discounted services (see below). This form must be filed ANNUALLY in order for discounts to continue. Patients must bring this form along with one of the following documented proof of income (POI).

Types of Proof of Income Documents:

  • At least 2 pay stubs from anyone working in the household
  • W2
  • Previous year's tax documents
  • Notarized letters stating income from all sources
  • Notarized document(s) from employers, family members or anyone providing support

If all documentation is not provided at the time of care patients may not be eligible to receive discounted services.
Also, services are not retroactively discounted. All services provided to patients must be paid for in full.

Form for Discounted Services:

In order to receive discounted services, the following form must be filled out. Patients can print and fill out information at home, or can elect to fill out all forms at the time of visit. Filling forms out before the visit will speed up the length of time it takes to see the provider.

Medical Insurance Accepted

  • Ohio Medicaid
  • Buckeye Managed Medicaid
  • CareSource Managed Medicaid
  • Molina Managed Medicaid
  • Paramount Advantage
  • United HealthCare Community Care
  • Medicare
  • Aetna Medicare Replacement
  • Anthem Senior Advantage
  • Secure Horizion Direct
  • United Medicare Replacement
  • Wellcare
  • Wellcare of Ohio
Commercial Insurance
  • Aetna
  • Anthem
  • Beech Street
  • Century Health
  • Cigna
  • Fiserv Health
  • Health Partners
  • Health Span
  • Humana
  • Medical Benefit
  • Medical Mutual
  • United Health Care

Dental Insurance Accepted

  • Anthem Dental
  • Buckeye Health Plan
  • CareSource Managed Care
  • Cigna Dental
  • Delta Dental (of Ohio, Indiana, and Kentucky)
  • Dental Care Plus
  • Guardian Dental
  • MetLife Dental
  • Molina Healthcare
  • Paramount Advantage
  • Superior Dental
  • United Health Community Plan

Don’t see yours listed? We contract with most insurance providers. Please check with your  insurance company to find out if we’re on your plan.