Payment for services is made on the day of your procedure. Payment can be made by cash (personal checks are not accepted), credit card, or insurance. If you are planning to pay with a credit card, please be sure that the card holder is with you and has valid photo ID. If the cardholder is unable to be present on the date of service, click here for the Remote Credit Card Authorization Form. The cardholder must complete this form with a copy of his or her identification and both sides of the credit card. Patients must bring the completed form with the required information to their appointment.
The following credit cards are accepted: VISA, MasterCard and Discover.
Our services are covered by most insurance plans. Philadelphia Women’s Center will verify your coverage prior to your appointment. If applicable, please be prepared to pay all co-pays at the time of service, including follow-up visits.
If you plan to use insurance, you will need to read and sign this insurance form so that we may bill your insurance company.Insurance Form
PA Medicaid does not cover abortion services except in the case of rape, incest, or threat to the woman’s life.
Financi al Assistance
If you are unable to pay for your procedure you may qualify for emergency funding, which could significantly reduce your fee. Please call and ask to speak to one of our phone counselors about funding options. You should be prepared to pay for as much of the procedure as you can on your own. Though we try our best to meet the needs of every woman, please keep in mind that emergency funding cannot be guaranteed as there are very limited funds available.
For more information about our fees, please see our form on fees and financial responsibility. Fees form PWC