to Your Home for Health Care on the North Shore of Lake Superior
Financial Assistance through Sliding Fee Scale ProgramIncome Eligibility Chart
Sliding Fee Scale Application 2016
Sliding Fee Scale Info Sheet 2016-2017
Oral Health Care Sliding Fee Scale Application Instructions
Oral Health Task Force Sliding Fee Scale Application Revised 11.1.2014
Sawtooth Mountain Clinic (SMC) offers financial assistance for patients through payment plans and a sliding fee scale program. The following list provides examples of the services covered by this program:
- CT Scan services available at North Shore Hospital that have been requested by a SMC doctor or nurse practitioner.
- Dental exams provided by Grand Marais Family Dentistry (Drs. Hedstrom and Lindquist).
- Doctor or Nurse Practitioner visits at any one of the Sawtooth Mountain Clinic sites in Grand Marais, Tofte or Grand Portage.
- Laboratory tests, X-ray and diagnostic tests at North Shore Hospital, which are requested by a Sawtooth Mountain Clinic doctor or nurse practitioner. Note that lab charges from Medtox will be covered for pathology and X-ray charges from Consulting Radiologists of Minneapolis will be covered for x-ray interpretations.
- Mental health counseling with Wayne Arnzen, MA, LP; Kelly Senty, MA, Steps of Change; Sherri Moe, MS, MFT; Suzabelle Janicek, ATR MFA MA Art Therapy; and/or at the Human Development Center.
- MRI services available at North Shore Hospital at the mobile unit that have been requested by a Sawtooth Mountain Clinic doctor or nurse practitioner. MRI benefits are limited to one per year per person.
- Outpatient consultation when the referral is made by a SMC doctor or nurse practitioner, the initial visit is covered. Call Steve at 218 387-2330 ext. 113, or Erin at ext. 153, before going to appointment.
- Physical and Occupational therapy services at North Shore Hospital, or with Becky Stoner PT at the Grand Marais Wellness Center - that are requested by a SMC doctor or nurse practitioner.
- Prescription drugs obtained at the Arrowhead Pharmacy or the Grand Marais Pharmacy in Grand Marais are covered when a SMC doctor or nurse practitioner writes the prescription. Prescriptions are not covered if they are written for items available over-the-counter, except for diabetic supplies – which are covered with an annual written prescription, from one of Sawtooth Mountain Clinic's providers.
- Vision Care performed by St. Luke's Opthalmology Associates located at North Shore Hospital - basic vision examps up to twice per year as necessary. Sliding Fee Scale will NOT cover eyeglasses or contact lenses.
- Hearing Aid Assistance for the purchase of hearing aids when arranged through hearing providers visiting SMC. Assistance will be reviewed on a case by case basis and must be pre-approved.
Income Eligibility 2016-2017
|Family size||Level A -
Patient pays 0% of charge*
|Level B -
Patient pays 10% of charge*
|Level C -
Patient pays 15% of charge*
|Level D -
Patient pays 20% of charge*
Patient pays 100% of charge