Low-Income Medical Card

If the patient, along with any household family members, meets the specified combined income cutoff for their household, they may be eligible for a discount offered by the state which brings your card processing fee down from $75 to $20 per year. Generally speaking, patients with Medicaid, SSID, and SNAP will qualify.  Please see the section below for examples of acceptable documentation of household income and links to the state website. This discount does not apply to the provider fee. We kindly ask that patients bring these documents to their appointment with Dr. Seas at Rapid Referrals.

Examples of Documentation

    (4)  If a low-income resident, documentation of household income, including:

            (a)  If employed, the resident’s wage stubs or earning statements for the past 30 days;

            (b)  If self-employed, the resident’s most recent federal income tax return and self-employment ledgers;

            (c)  Proof of all other income of the resident, including Social Security, Supplemental Security Income, workers’ compensation, unemployment benefits, Bureau of Indian Affairs general assistance, child support, rental income, veterans’ benefits, pensions, and interest income, for the previous 12 months; and

            (d)  The most recent financial statement from any of the resident’s checking accounts, savings accounts, certificates of deposit, credit union account, retirement account, stock, bond, or dividend; and

    (5)  The required fee, pursuant to § 44:90:02:17.