Johnson Health Center’s mission is to improve access to healthcare for all. One of the many barriers to individuals receiving healthcare is the inability to pay for services. At JHC, we offer a reduced fee program for patients who qualify financially. 

If you are experiencing difficulty affording healthcare, you can stop by any of our locations to pick up an application for our reduced fee program or download the application below. With our streamlined application process, you will have the opportunity to apply for reduced fee services at multiple locations (such as medical and dental) with the convenience of using just one form.

Once you have completed the forms and provided the required documentation, you will be assigned a fee schedule within 2 business days. With our reduced fee program, you will have the opportunity to receive health care at an affordable rate without sacrificing quality of care!

Reduced Fee Form    Reduced Fee Form – espanol



Good Faith Estimate

You have the right to receive a Good Faith Estimate explaining how much your medical care will cost. 

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
  • If you schedule a health care item or service at least 3 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 1 business day after scheduling.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
  • Make sure to save a copy or picture of your Good Faith Estimate.

To request a Good Faith Estimate, please contact the billing department at 434-455-2480, ext. 1130.

For questions or more information about your right to a Good Faith Estimate, visit or call 1-800-985-3059.