Service Area
FREEMED serves clients in ten Eastern Idaho counties:
- Bingham
- Bonneville
- Butte
- Clark
- Custer
- Fremont
- Jefferson
- Lemhi
- Madison
- Teton
We also serve clients in two
Northwest Wyoming counties and two
Southwest Montana counties. Live in Idaho, but not in FREEMED's coverage area? Contact
SHIBA at the Idaho Department of Insurance.
Your DoctorYour physician or other medical professional will have to authorize patient assistance applications and write prescriptions
Unaffordable?
Community Family Clinic, with offices in Blackfoot, Idaho Falls and Roberts, is a partially subsidized medical clinic charging sliding fees based on income. For more information or to make an appointment, call 528-7655.
Household Income Guidelines
While household income restrictions vary, many patient assistance programs use 200% of HHS Federal Poverty Guidelines (FPG) as a limit.
Some programs have limits as high as
350% of FPG.
Number of
People in
Household | Monthly
Income
FPG
| Annual
Income
FPG
| Monthly
Income
(200%)
| Annual
Income
(200%) |
| 1 | $903 | $10830 | $1805 | $21660 |
| 2 | $1214
| $14570
| $2428 | $29140
|
| 3 | $1526
| $18310
| $3052 | $36620 |
| 4 | $1838
| $22050
| $3675 | $44100 |
| 5 | $2149 | $25790
| $4298
| $51580
|
| 6 | $2461
| $29530
| $4922 | $59060 |
| 7 | $2773
| $33270 | $5545 | $66540
|
| 8 | $3084 | $37010
| $6168
| $74020
|
Each Additional
| $312 | $3740
| $623
| $7480
|
What you need to Apply for Patient's Assistance. Identification and Resident Verification
| Drivers License
or
State ID
or
Birth Certificate
or
Green Card
or
Resident Alien Papers
|
Insurance Information
(Not every document may apply to you.)
| Medicaid Denial Letter from Idaho Department
of Health and Welfare
Medicaid Card
Medical Insurance Card
Medicare Card (Red, White and Blue)
Medicare Prescription Program Providers Card
Medicare Supplemental Insurance Card
Prescription Insurance Card
|
Proof of Income and Financial Information
for the entire household. (Not every document may apply to you.) | Most Recent Bank Statement
and
Most Recent Federal Income Taxes (1040)
with W-2s & 1099s
or
Current Year Social Security Benefits Letter
or
Veterans Benefits
or
Workman's Compensation Benefits
Two Most Recent Pay Stubs
Health and Welfare Benefits Letters for:
Unemployment Benefits, Food Stamps, Child Support
|
List of Current Medications
| Request a Printout from your Pharmacy
or
Bring all your current bottles and boxes with you.
|
CALL FOR AN APPOINTMENT, (208) 528-6337
| |