- is eighteen years of age or older,
- resides in Montgomery County,
- does not have health insurance, and
- has a total household income of less than 250 percent of the poverty level established by the Federal Government.
Suggested Documentation - The following information is suggested for the eligibility interview:
- the most current tax returns for all members of the household who work;
- four of the most recent pay stubs for all members of the household who work;
- photo identification; utilities bills to verify the place of residence;
- mortgage papers, lease agreements, or a letter from the landlord verifying the prospective patient’s current address and the length of time this person has resided at the address.
Patient Brochure - Spanish
