Financial Assistance for Health Care
Important Documents You Will Need
Our Financial Counselor team may need these documents to complete your request for financial assistance. Your Counselor may need to review or make copies of the documents.
Proof of Your Identity from the Government You need one of these:
- Birth Certificate
- Passport
- Naturalization Papers
- Visa
- Permanent Resident Card
Family Information Bring any of these that you have:
- Marriage Certificate
- Divorce Decree
- Death Certificate
- Papers for each biological or legally adopted child. This could be a:
- Birth Certificate
- Legal Adoption Paper
- Birth Letter
Proof of Residency (Proof of Where You Live) You need at least one of these:
- Utility Bill (Must be from the last 60 days)
- Legal Mail (Must be from the last 60 days). Examples are:
- bank statement
- insurance bill
- major credit card bill
- letter from the county, state, or federal government
- Lease or Rental Agreement
- Letter from shelter, drug and alcohol treatment program
- Letter from a pre-release program
- There is an option if you cannot provide any of the above. You can use a signed letter from the head of the household where you live.
Proof of Income
- Pay stubs for the last 3 –12 months from every employer
- Report of gross income. Include dates of employment from temporary agencies
- Social Security Benefits Letter
- Statements of gross income from these:
- pension plans
- unemployment compensation
- workers’ compensation
- veteran’s administration
- rental income
- other
- Statement of alimony income or child support
- Interest income
- Current federal tax return. Include W-2. personal and/or corporate.
- Proof of extension for current filing period
- Proof of Non-Filing
|