Eligibility Guidelines

Category

Guideline

Residency

Minimum of 6 months of residency in a town within the regional service area of Franklin Memorial   Hospital (Franklin County)

Income basis

Annual adjusted gross income of last year below 200% of federal poverty level

OR

Proof of last three months' adjusted gross income below 200% of federal poverty level

• Must submit most recent Federal tax return as proof of annual income

• Other proofs of income may be required in addition to or in the absence of a tax return

Asset factor

 Ownership of assets will not be a factor in the determination of eligibility

Access to other insurance

• Must be ineligible for other insurance or health benefits program, such as Medicare or Medicaid.

• Eligibility of other family members for other health benefits will not disqualify current applicant.

• Temporary membership may be offered while applicant actively pursues other resources for which they may be eligible. Assistance provided.

Worker’s Compensation

Must disclose any pending worker's compensation covering medical claims; will not affect overall eligibility for Franklin Health Access

Liability lawsuit factor

Must disclose any pending lawsuits covering medical claims; will not affect overall eligibility for Franklin Health Access

Disability factor

Must disclose any pending disability insurance claims; will not affect overall eligibility for Franklin Health Access

Employer coverage option

If applicant or spouse is employed, they must be ineligible or not have the option to obtain health benefits through their employer.

The above notwithstanding, the Franklin Health Access may qualify such individuals for membership if the out-of pocket expenses associated with an employer's health insurance coverage is found to be a financial hardship as defined by the program.

Exceptionable circumstances

Special hardships or exceptionable circumstances will be considered provided applicant has submitted adequate documentation.

 Final determination will be made by the Franklin Health Access Program Director