Financial Assistance
We can help you
If you are uninsured and need help, you may qualify for financial assistance. If you receive any of the following services:
WIC
Food Stamps
Or
If your total yearly income is at or below 300% of the 2023 Federal Poverty Income Limits (FPIL)
| Persons In family or Household | January 2023 Poverty Guidlines 300% |
| 1 | $43,740 |
| 2 | $59,160 |
| 3 | $74,580 |
| 4 | $90,000 |
| 5 | $105,420 |
| 6 | $120,840 |
| 7 | $136,260 |
| 8 | $151,680 |
Financial Eligibility List of documents
Identification of household members (all that apply will be required):
The head of household and spouse (if applicable) will need to provide picture identification
Social Security cards for everyone in household
Birth certificates for children under 18 ( will accept copies from hospital, courthouse or TDHS)
Residency Verification
Proof of being a Martin County resident, may include but not limited to:
Current utility bill (such as water, gas or electricity)
Most current property tax receipt
Current rent receipt or lease agreement showing applicant’s address
Driver’s license or other government issued identification
Proof of Income
Proof of income will include all of the below that apply to you and your household.
Current check stubs
If applicant does not receive check stubs from employer they will be required to have employer complete an Employment Verification Form.
Prior Year’s income Tax Return(**preferred, if available)
Unemployment Benefits
Social Security Benefits (from SSA Office)
Retirement Income
Workers Compensation Benefits
Income Producing Property
Proof of Child Support ( from Attorney General’s Office, a Decree, or check stubs)
Royalties
Alimony
Investment Income
Current bank statement(s) may be required
Require documentation for applicants listing zero (0) income may include but not ne
limited to the following:
Proof of eligibility screening. If patient refuses to cooperate or comply with eligibility screening, they will automatically be denied coverage.
Reporting NO/Zero Income
Proof that they have applied for SSI benefits
Applicants having no income who are eligible to work will be required to shoe proof of registration with the Texas Workforce Commission
Notarized in-kind letter/letters ( see approval process located in policy)
Proof of receiving Food Stamps /TANF
Self-employed applicants
Applicants who are self-employed must provide the prior year’s income tax return. If this is not possible the applicant must complete the self-employment form and supply us with supporting documents such as business receipts, banks statement (both individual and business,) audited financial statements, etc.
** In order to determine if you are eligible, our Financial Advisor will need to visit with you in person. Please call 432-607-3237 for an appointment Proof of income will be required. Cosmetic Surgeries do not apply.