Skip to main content

Home / Services / Indigent Health Care / Polk HealthCare Plan / Eligibility and Requirements

Eligibility and Requirements

The Polk HealthCare Plan was created as a last resort for residents with no other option for healthcare coverage. To qualify for membership in the Polk HealthCare Plan you must:

  • Be a full-time resident of Polk County
  • Have no health insurance coverage or medical coverage
  • Have no or low household income
  • Provide a Social Security number
  • Provide a valid Florida issued driver license or ID card
  • Provide two proofs of residency and proof of income
Federal Poverty Level Income guidelines for PHP effective October 1, 2023 based on 200% of Federal Poverty Guidelines
Persons in Family/HouseholdMaximum $ Income/MonthMaximum $ Income/Year
1$2,510$30,120
2$3,407$40,880
3$4,303$51,640
4$5,200$62,400
5$6,097$73,160
6$6,993$83,920
7$7,890$94,680
8$8,787$105,440

2024 Federal Poverty Level as published in the Federal Register Notice, effective January 12, 2024. For families/households with more than eight persons, add $5,380 annually for each additional person.

What documents do I need to apply?

Any (1) of the following documents will meet the requirement for proof of income:

  • Court-ordered child support or alimony payments
  • Expense records (bank/credit statement, profit and loss statement)
  • Pay stub(s) (one month of pay stubs)
  • PELL Grant Award Letter
  • Pension documents
  • Proof of rental income
  • Self-employment Tax Form
  • Social Security Award Letter
  • Tax Return
  • Unemployment Award Letter
  • Verification of Earnings Form
  • Workers’ Compensation

Any (2) of the following documents will meet the requirement for proof of residency:

  • Driver License / State Identification Card
  • Federal or State agency Award Letter / Check
  • Lexis Nexis Report
  • Proof of employment (Ex: Pay stub with home address listed)
  • Property tax statement
  • Proof of homestead ownership / purchase
  • Rental verification completed by landlord
  • Rent receipt / lease agreement
  • Shelter/Residential Facility Letter
  • Utility Bill (electric, water, gas bill)
  • Vehicle Registration
  • Verification of homelessness from Polk County Court Services Office
  • Voter Registration Card