Indigent Health Care

• Determines eligibility for health care services
• Processes provider's bills
• Makes referrals to other agencies
• Maintains records
• Complies with HIPAA regulations

• Physician visits
• Inpatient and outpatient hospital services
• Laboratory and X-ray services
• Maximum of 3 prescriptions per month
• Limited diabetic supplies

1. Review Eligibility 
   1. Review basic eligibility guidelines and income qualifications.
   2. Call 972-204-7620 to do an eligibility screening
2. At the end of the eligibility screening, the county representative will tell you the next step.

Forms

• Application for Health Care Assistance (PDF)
• Assistance Verification (PDF)
• Residence Verification (PDF)
• Authorization to Release Information (PDF)
• Request for Information (PDF)