Menu

Becoming a Patient

  • 2016 Federal Poverty Level (150%)

  • Medical

    To qualify to become a medical patient, individuals must be:

    • A resident in one of the following counties: Indiana- Adams, Allen, DeKalb, Huntington, Kosciusko, LaGrange, Noble, Steuben, Wabash, Wells, Whitley; Ohio- Defiance, Paulding, Van Wert, Williams
    • Age: 18 years or older
    • Have no medical insurance (including Medicaid, Medicare or HIP)
    • Fall at or below 150% of the Federal Poverty Level

    Your donations help to cover the costs of providing your care

    • Please donate $5 for a medical visit

    To become a medical patient you must register between 8:30 and 11:00 a.m. weekdays and bring all 7 itmes from the list below:

    • 1. Photo identification (drivers license, employee ID, etc.).
    • 2. Proof of residence in County supplied by mail in your name and current address (such as a bill or lease). If person is not a U.S. citizen, you must provide a resident card, Green card, or an Embassy card.
    • 3. Proof of all household income for one month:
      • 1 month of continuous paycheck stubs (within the last two months) if employed.
      • Statement of household income (or lack of income) which includes legal spouse and children under 21 (25 if full time student). If other persons living in the home are contributing financially to the household, their contributions must be declared as income. If you are of age and living at home or with relatives in their home, or with another person in his or her home, you must bring a letter from the person with whom you are living stating that they are not financially responsible for you and that he/she is providing you free room and board.
      • Documentation showing your Social Security, Disability, SSI, Unemployment, Pension, Alimony and Child Support
    • 4. Most recent tax return (if filed).
    • 5. Proof that you have applied for Unemployment, Medicaid and/or Disability. This can be an application or denial letter from the appropriate agency. Veterans are not accepted as patients unless they furnish a letter from the Veterans Administration declaring their ineligibility for VA benefits.
    • 6. Names and address of all physicians, hospitals, etc. that have treated you in the past year.
    • 7. The names, dosages and frequency of all medications you are taking.

    You must have all the above documentation with you at the time of registration as applications cannot be processed without them.

  • Dental

    To qualify to become a dental patient, individuals must be:

    • A resident in one of the following counties: Indiana- Adams, Allen, DeKalb, Huntington, Kosciusko, LaGrange, Noble, Steuben, Wabash, Wells, Whitley; Ohio- Defiance, Paulding, Van Wert, Williams
    • Age: 18 years or older
    • Have no dental insurance (including Medicaid or HIP Dental Benefits)
    • Fall at or below 150% of the Federal Poverty Level

    Matthew 25 Dental clinic does provide treatment for Veterans and patients that have Medicare (since Medicare does not provide dental coverage).

    Your donations help to cover the costs of providing your care

    • Please donate $5 for a dental walk-in visit
    • Please donate $10 for a scheduled dental appointment

    To become a dental patient...

    You must come to a Walk-In Clinic on Monday, Wednesday or Thursday at 8:15am or Tuesday at 5:30pm. The Dental walk-in clinic sees patients on a lottery basis and patients must be present at the begining of each walk-in clinic. Emergencies will be seen that day, and non-emergencies will be determined on a case-by-case basis at that time.

    Emergencies: issue defined as pain, discomfort or swelling.
    Non- Emergencies: Issues such as complete exams, cleanings, restorations, partials and dentures.

    To become a dental patient you must bring all 5 items from the list below:

    • 1. Photo identification (drivers license, employee ID, etc.).
    • 2. Proof of residence in County supplied by mail in your name and current address (such as a bill or lease). If person is not a U.S. citizen, you must provide a resident card, Green card, or an Embassy card.
    • 3. Proof of all household income for one month:
      • 1 month of continuous paycheck stubs (within the last two months) if employed.
      • Statement of household income (or lack of income) which includes legal spouse and children under 21 (25 if full time student). If other persons living in the home are contributing financially to the household, their contributions must be declared as income. If you are of age and living at home or with relatives in their home, or with another person in his or her home, you must bring a letter from the person with whom you are living stating that they are not financially responsible for you and that he/she is providing you free room and board.
      • Documentation showing your Social Security, Disability, SSI, Unemployment, Pension, Alimony and Child Support
    • 4. Proof that you have applied for Unemployment, Medicaid and/or Disability. This can be an application or denial letter from the appropriate agency. Veterans are not accepted as patients unless they furnish a letter from the Veterans Administration declaring their ineligibility for VA benefits.
    • 5. The names, dosages and frequency of all medications you are taking.

    You must have all the above documentation with you at the time of registration, as applications cannot be processed without them.