AmeriCares Free Clinic of Norwalk

ELIGIBILITY CRITERIA

The AmeriCares Free Clinics are open to those who are uninsured and who are without the financial resources to afford medical care.

To be eligible you must:

Have no public or private health insurance. If you have catastrophic insurance with an affordable co-payment you might qualify.
Meet income guidelines – less than 200% FPL (see below), and bring income verification.
Be a full-time resident of the area (for a list of eligible towns click here)
Provide photo identification
Provide income verification upon request
Be accompanied by a parent or legal guardian with identification if you are under 18 years of age

Financial Eligibility Criteria for Patient Services

2009 Income Guidelines

The AmeriCares Free Clinics program will provide health care services, free of charge, to eligible individuals with a total household income under 200% of the Federal Poverty Level. For 2009, this level of income would be:

Household
size

Weekly   income

Monthly income

Annual   income

1

$417

$1,805

$21,660

2

$560

  $2,428

$29,140

3

$704

$3,052

$36,620

4

$848

$3,675

$44,100

5

$992

$4,298

$51,580

6

$1,136

$4,922

$59,060

For each addl. Person add

$144

$623

$7,480

You may be asked to provide proof of household income (i.e. tax returns, pay stubs, unemployment checks) in order to ensure eligibility or to help obtain medicines at no cost to you.

Eligible Towns

The AmeriCares Free Clinics serve residents of the following towns:

Danbury Clinic	Norwalk Clinic	Bridgeport Clinic
Danbury Bethel New Milford Brookfield New Fairfield Redding Ridgefield Newtown	Norwalk Darien New Canaan Westport Wilton Weston	Bridgeport Stratford Fairfield Westport Monroe Trumbull Milford Shelton

Clinic Expectations

The AmeriCares Free Clinics have limited resources and cannot provide care to all those in need. The Clinic will, therefore, give priority to those patients who demonstrate their willingness and determination to forge a real partnership, working together to improve their health status.

We expect patients to be honest about their medical, financial and insurance status
We expect patients to be compliant with their medical treatment as prescribed
We will not treat abusive or abrasive patients
We will not treat patients under the influence of drugs or alcohol
We expect patients to come to the clinic clean and appropriately dressed

If any of the above expectations are violated, AFC reserves the right to terminate services immediately, either temporarily or permanently. In such cases, a copy of the patient’s records will be made available, at the patient’s request, to the health care provider of his/her choice. The AmeriCares Free Clinic will give priority to patients who want to forge a real partnership to work towards their improved health.