Eligibility

Eligibility Requirements

The Free Clinic serves people who meet all of the following criteria:

• Resident of Harrisonburg City or Rockingham County
• Without any type of medical insurance, including Medicaid and Medicare
• Gross family income (before taxes) less than 200% of the Federal Poverty Guidelines. This means that if you live alone, your income before taxes cannot be more than $20,800 a year to receive services. For a family of four, your income cannot be over $42,000.
• Working at least 16 hours per week, on disability, or deemed unable to work by Free Clinic clinical staff. People who are caring for young children, the elderly and persons with disabilities can be considered working.

All Free Clinic patients must provide their Social Security Number or documentation of legal residency in this country in order to receive services.

The Free Clinic will provide services to all who meet the criteria outlined in this policy without regard to race, ethnic origin, religion, language capability, gender, age, or disability.

Eligibility Appointments

The first time you come to the Free Clinic, you will have an eligibility appointment. If you are approved, you will receive an eligibility card that is usually good for six months. You must bring this card with you to every appointment. Without an active eligibility card, you cannot be seen at the Clinic. It is your responsibility to call the Clinic at 433-5431 about two weeks before your card expires to schedule your next eligibility appointment.

What to bring to your eligibility appointment:

1. Proof of all household income for one month
Examples of household income are

• Pay stubs for one month
• Food stamp award letter
• Proof of income letter (with a money amount on it) from whoever is providing you food and shelter
• Social Security statement with the amount you receive or copies of your SSA check
• Unemployment checks
• Current bank statement if you have direct deposit
• Copies of checks from clients for one month if you are self-employed

Note: The following are considered members of your household--
Yourself, your spouse, your minor children, disabled children over the age of 18, and grandchildren for whom you have custody.

2. Current 1040 Federal Income Tax form (if one was filed). After April 15 of each year, it is your responsibility to bring your new 1040 Income Tax form to the Clinic.

3. Proof of residency in Harrisonburg or Rockingham County
This can be your driver's license, lease, food stamp letter, utility or medical bill or any mail you have received that has your name and your current address.

4. Your Social Security number.

5. Proof of your disability status, if you have applied for disability
This can be a letter from Social Security saying you have applied for disability or have appealed their decision, or a letter from your lawyer telling us the status of your disability application.