To be eligible as a patient of Mercy in Me Free Medical Clinic applicants must meet following criteria:
1. Be 18 years old or older. 2. Be a resident of Chesterfield County. 3. Not be pregnant or think she is pregnant. 4. Not have Medicaid, Medicare, private health insurance, or VA benefits. 5. Household income must meet 175% poverty level or below. 6. Eligibility recertification will be determined every 6 months. 7. Must demonstrate proof of income such as (a) employment, (b) unemployment or (c) disability. 8. If no source of income must be a full time care-giver prevented from working outside the home and provide an accepted letter from the physician in care of the person to whom they provide full time care explaining their need for the applicant to provide the full time care.
Provide a narrative summary from a Chesterfield County physician explaining why the applicant cannot work.
If not working, the applicant may be made a temporary patient for up to 3 months while actively pursuing work with proof provided satisfactorily to the Board.
Required Documentation for Eligibility Determination:
1. Driver's license or state picture ID with active Chesterfield County ID. 2. Power bill or water bill to prove residence in Chesterfield County if needed. 3. Social Security Card or legal document with Social Security number. 4. Previous year's Tax Return, including schedule C if filed. 5. Proof of income for all in household: a. Last 4 pay stubs if paid weekly or last 2 if paid biweekly. b. If no pay stubs, a statement from employer signed on letterhead or signed and notarized stating hourly wage and hours worked. c. If receives a Social Security benefit, provide statement. d. If food stamps, provide DSS household summary.