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 for all people in the household who work (last year's federal tax return).  All applicants must provide a copy of a Medicaid denial letter.

Any applicant who receives food stamps, child support, unemployment compensation or any kind of Social Security income must provide copies of those benefits as well.

It is best to call the clinic ahead of time to make sure you have all the required information BEFORE coming to the clinic to qualify as a patient.

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 2010 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