Texas residents who reside in Harris County have the option of applying for Harris Health, formally known as the Gold Card, which is a medical assistance program offered by the Harris County Hospital District (HCHD). Depending on your household income you could qualify for medical assistance that helps to alleviate the cost of medical services that can accrue without health insurance. With Harris Health you are still required to pay a minimum payment at each medical appointment with the exception of prenatal and pediatric appointments. To apply for Harris Health you must send a completed application to the Harris County Hospital District.
Request or Download the Application
Obtain a copy of the application for Harris Health from one of the five Harris County Hospital District Financial Assistance Program eligibility offices or from the HCHD website (hchdonline.com). Applications are available in English, Spanish and Vietnamese.
List Your Household Information
The first part of the application requires you to provide your name, maiden name – if applicable – address, phone number and marital status. List the name, age, date of birth, Social Security number, sex, race, employment status and legal status of every person living in your home, including yourself.
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Add Employment Details
After you list the names of each person in your household with a paying job, you must supply further employment details. This includes the employer's name, the total income and the frequency of the pay periods for each job.
Include Any Pregnancies and Social Security Income
Before finalizing the application, you must answer questions and provide information about whether or not anyone in your household is pregnant, that individual's expected due date, whether or not anyone in the home has medical insurance and with whom, if anyone receives Social Security Income and whether or not anyone is unemployed.
Supply Supporting Documentation
Once you sign and date the application in the presence of a witness, you'll need to collect documents to support the information in the application. Make copies of your and your spouse’s photo identification, immigration paperwork (such as green cards or alien registration numbers), health care policies for anyone in your household with medical insurance, Medicare information, birth certificates for each of your children, income tax returns, pay stubs for the past month, W2 forms and proof of your residency. To prove your residency, you may use your mortgage statement, rental contract, apartment lease, utility bills or financial statements that show your name and current address.
Submit the Application
Take or mail your application and supporting documents to: HCHD Financial Assistance Program, P.O. Box 300488, Houston, TX 77230. Once your application is reviewed, an appointment is scheduled for you to meet with a HCHD employee to discuss your application. You are notified by mail if and when you are approved for Harris Health.
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