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You Will Need

What you need to apply for FREEMED assistance.

 Identification and Citizenship Verification


SS Card

Drivers License
or
State ID
or
Birth Certificate

Resident Alien Papers/Card


Insurance Information
 (not every document may apply to you.)

 

 

 

 

 


Current Year Medicaid Denial Letter (from Idaho Department
of Health and Welfare)

Medical Insurance Card

Medicare Card (Red, White and Blue)

Medicare Prescription Program Providers Card

Medicare Supplemental Insurance Card


Proof of Income and Financial Information
for the entire household.  (not every document may apply to you.)


Current Year Federal Income Taxes (1040 Pages 1&2)

If self-employed bring Schedule C with W2 forms.

or
Current Year Social Security Benefits Letter
or
Current Year Veterans Benefits
or
Current Year Workman's Compensation Benefits


Three Most Recent Pay Stubs

Most Recent Bank Statement

Current Year Health and Welfare Benefits Letters for:
Unemployment Benefits, Food Stamps, Child Support


List of Current Medications


Bring all your current bottles and boxes with you.

or

Request a Printout from your Pharmacy


CALL FOR AN APPOINTMENT, (208) 528 6337