Eligibility Requirements

To become a patient of Good Samaritan Health Clinic, you must be a resident of Cullman County (acceptable proof is a utility bill from where you live), have two forms of identification (such as driver's license, Social Security card or birth certificate) and proof of income (last year's federal tax return.  If you did not file a federal return, you must provide a copy of your Medicaid denial letter).  You must also not be covered by Medicare, Medicaid, veteran's or private insurance.

Our income guidelines (you can not make more than the incomes shown below) for 2009 are:

                            Annual

No. in                 Household

Household              Income

      1                    $21,660

      2                    $29,140

      3                    $36,620

      4                    $44,100

      5                    $51,580

      6                    $59,060

For each additional

person, add            $ 7,480