The Live & Love Well Scholarship Program provides individuals and couples with a discounted rate based on annual household income. Applicants are required to apply for the Live & Love Well Scholarship Program, this includes providing income verification. Scholarships are granted for 6-months and revisited biannually. Should you find yourself in a different financial position prior to review, please inform me so another individual can access fee-reduced, quality care.

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Statements & Insurance

Detailed service statements arrive securely by email on a monthly basis.  As always, I strongly encourage insured patients to inquire with their insurance companies about out-of-network benefits. If your insurance plan includes these benefits, I will ensure that all relevant services and diagnostic codes needed to seek reimbursement from your carrier are included in the statement.  Many clients receive supplementary financial relief by taking these additional steps to fully utilize their benefits.  

 

Identifying Financial Need

Below, you will find a chart that allows you to identify your scholarship qualification based on annual household income and the 2021 Census Bureau Median Family Income based on Family Size for the State of Hawaii; these guidelines assist clinics across the country in identifying and supporting individuals and families who are eligible for financial assistance from the medical community.

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Live & Love Well Scholarship Program Differentiators  

• The Live & Love Well Scholarship Program allows clients to seek financial assistance, taking into consideration median family income and the number of individuals in each household.

• Dr. Simon provides a 25% discount on all services to Public Service Employees, including Police, EMT/Paramedic, Firefighters, Teachers, and All Active/Retired Military Personnel. 

• Dr. Simon is committed to honoring the Kanaka / Native Hawaiians and their ancestors, on who's land she and her family found their new home.  Please speak with Dr. Simon directly to identify a service fee that works for your family.

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Live & Love Well Scholarship Program Qualifications/Guidelines:

1. Assessing annual or monthly household income: Total household income is calculated by adding salaries of all contributing household members, as well as annual financial assistance from extended family members or trusts, child support, maintenance, financial gifts, dividends, unemployment, and all other forms of taxable income.

2. Young adults living at home (or independently) who receive financial support from a parent/guardian: Please use rates based on the household income of the supporting party; income verification of the supporting party is required to receive the scholarship.

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Required Documentation

• To request a Live & Love Well Scholarship, please provide the following: 

  • Verification of household income in the form of a Pay Stub, Tax Return, or Letter from a Certified Accountant. 

  • *Please note the information submitted must include All forms of household income you or others receive. 

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Scholarship Renewal Requirements

Your rate will be set based on the documentation submitted and utilizing the chart below. Your discounted rate will be revisited biannually. 

• Dr. Simon maintains the right to deny, alter, cancel, negotiate or not renew any individual’s scholarship request, position or rate, at her sole discretion.  In addition, Dr.Simon maintains the right to alter or discontinue the Live & Love Well Scholarship Program at any time. 

Family Income Ranges for Financial Assistance. Federal Poverty Level ‘FPL’ is Determined by the 2021 Census Bureau Median Family Income by Family Size for the State of Hawaii and Colorado.  Use the chart below to determine your rate.