Eligibility requirements vary depending on the service provided. Some services are a flat fee and others have a fee based on a sliding scale. Sliding scale means that the fee is relative to your income. Financial eligibility is determined annually and whenever there is a change in financial status. You must have identification and proof of income when services are provided.
Proof of Income – you will be required to provide one or more of the following:
- Pay Stubs – provide either the most recent with “Year to date” income listed, or 3 most recent
- W-2 Form or income tax return for most current calendar year
- Employer’s written statement regarding weekly, monthly, or yearly gross income
- Unemployment notice from VEC (Virginia Employment Commission)
- Letter of Termination/Layoff notice from previous employer
- Statement of Social Security benefits or other benefits
- Military LES (leave and earning statement)
- Foster care statement from Social Services
- Food stamps – Letter of eligibility
- TANF
- Medicaid card for current month
- Minors if not working must provide parent’s income to determine eligibility
Proof of Identity
- Medicaid Card/HMO Card for each person being certified
- Driver’s License
- Birth Certificate or Crib Card
- Social Security Card
Proof of Virginia Residence
- Medicaid Card/HMO Card for each person being certified
- Driver’s License
- Rent/Mortgage Receipts
Please bring Shot Records if you have them.
If you have questions or need more information regarding eligibility requirements, please call 748-1750.