Patient Eligibility Guidelines
Those interested in being seen at the SHARING Clinic must meet the following criteria:
- No health insurance
- Annual household income below 138% of the Federal Poverty Level based on 2021 guidelines (see chart below)
- Complete a proof of income application that includes at least one of the following:
- Current pay stubs for all household incomes
- Last federal income tax return
- Documentation of any other income sources or means of support
| 2021 Federal Poverty Guidelines | |||
|---|---|---|---|
| HOUSEHOLD SIZE | 138% | HOUSEHOLD SIZE | 138% |
| 1 | $17,774 | 6 | $49,100 |
| 2 | $24,039 | 7 | $55,365 |
| 3 | $30,304 | 8 | $61,630 |
| 4 | $36,570 | 9 | $67,896 |
| 5 | $42,835 | 10 | $74,161 |
| Calculations based on data from U.S. Department of Health and Human Services | |||
Criterios de Elegibilidad
Todos los que quieren obtener cuidado médico en una de nuestras clínicas deben cumplir con los siguientes criterios:
- Ningún seguro de salud
- El ingreso anual debe estar debajo de 138% del nivel federal de pobreza (vea los números por debajo)
- Usted debe llenar un formulario y presentar la prueba sobre los documentos de ingresos (por ejemplo, comprobantes/talones/recibos de pagos/cheques o Formularios W-2 Declaraciones de ingresos e impuestos)
| Índice Federal de Pobreza 2021 | |||
|---|---|---|---|
| TAMAÑO DE LA FAMILIA | 138% | TAMAÑO DE LA FAMILIA | 138% |
| 1 | $17,774 | 6 | $49,100 |
| 2 | $24,039 | 7 | $55,365 |
| 3 | $30,304 | 8 | $61,630 |
| 4 | $36,570 | 9 | $67,896 |
| 5 | $42,835 | 10 | $74,161 |
| Cálculos basados en datos del Departamento de Salud y Servicios Humanos | |||
Impresión