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Uninsured patients or guarantors who provide proof of eligibility for one of the programs listed below, individually or through the benefits provided to their family, are automatically eligible to receive assistance. Additionally, if you are homeless or filling out the application for a deceased patient with no estate, you are considered presumptively eligible.

The qualifying programs are:

  • TANF
  • WIC
  • SNAP
  • Indiana Children's Special Health Care Services
  • Medicaid (you, or a dependent)
  • IN Free or reduced lunch program
  • Low Income Energy Assistance Program
  • Other Federal or State Income-based program not listed

If you are presumptively eligible because of any item listed above, answer yes.

You will be required to provide proof of your eligibility.