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NORTH CAROLINA STATEWIDE FAMILY PLANNING PROGRAM
<br />
<br />SLIDING FEE SCALE
<br />
<br />FAMILY SIZE
<br />
<br />FREE Monthly Range
<br /> Annual Range
<br />
<br />1 2 3~ 4
<br />$ 511 - under $ 668 - under $ 825 - under $ 982 - under
<br />$ 6,132 - under $ 8,016 - under $ 9,900 - under $11,784 - under
<br />
<br />20% Monthly Range $ 512 - $ 613 $ 669 -$ 801 $ 826 - $ 990
<br /> Annual Range $ 6,193 - $ 7,356 $ 8,017 - $ 9,612 $ 9,901 -$11,880
<br />
<br />40% Monthly Range $ 614 - $ 715 $ 802 - $ 934
<br /> Annual Range $ 7,357 - $ 8,580 $ 9,613 - $11,208
<br />
<br />60% Monthly Range $ 716 - $ 817
<br /> Annual Range $ 8,581 - $ 9,804
<br />
<br />80% Monthly Range $ 818 - $ 919
<br /> Annual Range $ 9,805 - $11,028
<br />
<br />100% Monthly Range $ 920 - over
<br /> Annual Range $11,029 - over
<br />
<br />$ 935 - $ 1,067
<br />$11,209 - $12,804
<br />
<br />$ 1,068 - $ 1,200
<br />$12,809 - $14,400
<br />
<br />$ 1,201 - over
<br />$14,401 - over
<br />
<br />$ 991 - $ 1,155
<br />$11,881 - $13,860
<br />
<br />$ 1,156 - $ 1,320
<br />$13,861 - $15,840
<br />
<br />$ 1,321 - $ 1,485
<br />$15,841 - $17,820
<br />
<br />$ 1,486 - over
<br />$17,821 - over
<br />
<br />$ 983 - $ 1,178
<br />$11,785 - $14,136
<br />
<br />$ 1,179 - $ 1,374
<br />$14,137 - $16,488
<br />
<br />$ 1,375 - $ 1,570
<br />$16,489 - $18,840
<br />
<br />$ 1,571 - $ 1,766
<br />$18,841 - $21,192
<br />
<br />$11,767 - over
<br />$21,193 - over
<br />
<br /> 5
<br />$ 1,139 - under
<br />$13,668 - under
<br />
<br />$ 1,140 - $ 1,367
<br />$13,469 - $16,404
<br />
<br />$ 1,368 - $ 1,595
<br />$16,405 - $19,140
<br />
<br />$ 1,596 - $ 1,823
<br />$19,141 - $21,876
<br />
<br />$ 1,824 - $ 2,051
<br />$21,877 - $24,612
<br />
<br />$ 2,052 - over
<br />$24,613 - over
<br />
<br /> 6
<br />$ 1,296 - under
<br />$15,552 - under
<br />
<br />$ 1,297 - $ 1,555
<br />$15,553 - $18,660
<br />
<br />$ 1,556 - $ 1,814
<br />$15,661 - $21,768
<br />
<br />$ 1,815 - $ 2,073
<br />$21,769 - $24,876
<br />
<br />$ 2,074 - $ 2,332
<br />$24,877 - $27,984
<br />
<br />$ 2,333 - over
<br />$27,985 - over
<br />
<br />The dollar figures represent monthly and annual gross income.
<br />Family size refers to those who are supported by or dependent on that income.
<br />Patients who are certified for Medicaid or Title XX will receive free service. ·
<br />Those falling below Title XX income eligible but not certified will be assessed a nominal fee (15%) of full charges.
<br />A waiver of all family planning fees is applied to teenagers.
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