QUALIFICATION REQUIREMENTS

If you are a resident of Cullman County without any health insurance coverage, meet certain income requirements, and are between the ages of 19 and 65 you may be eligible to receive health care services through Good Samaritan Health Clinic.

To become of patient of Good Samaritan Health Clinic, you must be a resident of Cullman County, have two forms of identification, and provide proof of all household income. You must not be covered by Medicare, Medicaid, Veteranís or private insurance. All applicants must provide a Medicaid denial letter. Our income guidelines for 2017 are based on income from 2016 and are as follows:

PERSONS IN HOUSEHOLD

POVERTY GUIDELINE
(250% Federal Poverty Guideline)

1

$30,150

2

$40,600

3

$51,050

4

$61,500

5

$71,950

6

$82,400

7

$92,850

8

$103,300

Each Additional Person

$4,180

 

Income includes ALL income such as unemployment, alimony, child support, food stamps, disability, social security, SSI, AFDC, retirement, VA benefits, etc. received by everyone in your household.

 

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