Financial Assistance Program

Financial Assistance Program

InSource Diagnostics maintains a Financial Assistance Program which may waive a portion or all of the charges after determining that a patient is in need of financial assistance. Eligibility for financial assistance considers total income, number of members in the household, and certain monthly expenses.

Maximum Patient Responsibility*
Adjusted Household Gross Income
Household Size0-$50,000$50,001-$75,000$75,001-$100,000$100,001-$125,000$125,001-$150,000$150,001+
1$20$105$215$385$470$500
2$0$10$125$290$375$490
3$0$0$30$200$285$400
4$0$0$0$105$190$300
5+$0$0$0$15$100$210

*General guidelines for maximum "out-of-pocket" costs for ordered tests. Your specific individual costs may vary depending on your expenses - number of tests/year, mortgage/rent, auto payments, college tuition, and medical expenses. Please contact InSource Diagnostics Billing Department for a more detailed analysis of your financial responsibility.