Eligibility Requirements

Financial Eligibility

The Florida Department of Health in Charlotte County (DOH-Charlotte) strives to make our services available to as many people as possible. 

Some services are offered on a sliding fee scale to eligible individuals. 

The cost of a service depends on your ability to pay. Your ability to pay is determined by the information you provide at the time of your eligibility. You will be asked to provide documentation in order to determine your eligibility. The more information provided at the time of your eligibility, the easier it is for us to assist you.  

We do not schedule eligibility appointments. Please arrive 1 hour prior to your scheduled appointment with the provider to complete the eligibility screening. Our lobby hours are 8 a.m. - 5 p.m.

The list below is for informational purposes only. Additional information may be required on a case-by-case basis. 

• Photo ID (U.S. or foreign government ID, or other ID with supervisor approval)
• Social Security cards/numbers (all family members)

Verification of Alien Status (if applicable - for non-U.S. citizens)

May include Permanent Resident Alien cards (”Green Cards”), Employment Authorization Document, valid passport, I-94 form, visas, and any other Immigration or Homeland Security documents

Proof of Insurance (if applicable)

Proof includes a health insurance card with deductible/co-pay information; Medicaid, Medicaid HMO and/or Medicare card; and private insurance cards for any health, dental or prescription plans.

If you have no health insurance coverage, you may be eligible for Medicaid. Take the survey at MyFlorida.com/AccessFlorida to determine if you qualify.

Florida KidCare provides insurance coverage for eligible children under age 19. For additional information or to apply go to: FloridaKidCare.org

Verification of total gross household income for the four most recent weeks, which may include:

• Pay stubs (or for a new job, provide a letter from your employer stating hours, rate of pay, and how often paid)
• Bank statements - from most recent month for all accounts
• Other income - proof of monthly amount of any income from Social Security, alimony, child support, Unemployment / Workers Compensation, pensions, trusts, bank accounts, rental income, etc.
• If self-employed, provide most recent 3 months’ business ledgers/records and most recent 3 months’ bank statements

If you are supported by someone else, provide a written statement of support including that person’s name, address, and phone number; the date, and the dollar amount of the support you receive each month.