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
Persons in Family/Household | Maximum $ Income/Month | Maximum $ 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 Jan. 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 one 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 two 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