We’d love to welcome you into the LVIM Circle of Caring!

Our mission is to provide, free, high-quality, and compassionate outpatient medical, dental and mental health care to the working uninsured of Polk County. See if you qualify!

In order to apply to become an LVIM patient, we must first be sure you’re eligible to receive LVIM services.

Eligibility Requirements
Let us help you determine your eligibility

Are you a
Polk County resident?

Are you

Is your income below 200% of the Federal Poverty Level (FPL)?*

Are you working or a full-time student? Or, is anyone in your household working?

Check Your Eligibility & Apply In Person

If you’d prefer to speak with a member of the LVIM team and have them assist in checking your eligibility and completing an application, please call (863) 688-5846, ext 104 or 105.

Members of our enrollment team are available Monday through Friday, 8 a.m. to 5 p.m.

¿No hablas Inglés? [insert message for spanish speakers here]

Eligibility Frequently Asked Questions

Before you check your eligibility and get started on your LVIM enrollment application, you may have some questions. We can help!

No. You just need to be a resident of Polk County, FL AND you do need a valid form of identification. A passport or ID from your country of origin is sufficient.

No problem! You can verify your residency by completing the Declaration of Domicile form.

For LVIM eligibility purposes, a household is defined as one or more persons living in one dwelling place who are related by blood, marriage, or law or who share assets.

LVIM can see you for medical services only.

Depending on the levels of your coverage, you may still qualify for LVIM. Please call us to ask about your particular situation. 863.688.LVIM x104

No problem! If your place of work does not provide you with paystubs, you can complete the Verification of Earnings or Certification of Zero Income forms. If you are self-employed, you’ll need to submit your Schedule SE and / or your most recent Profit and Loss Statement.

Working can take many forms. We accept individuals who work in the following ways:

  • A traditional job (receive paystubs)
  • Work for cash
  • Self-employed
  • Caregivers – Mothers/Fathers caring for children; caring for elderly parents; caring for a disabled spouse; providing care in exchange for room and board
  • Full-time students
  • Recently unemployed
  • Persons who are disabled and awaiting approval for disability income
  • Persons receiving Social Security Income as their only source of income
  • Full-time students over the age of 18
  • Residents of partner agencies: Lighthouse Ministries, Salvation Army, Talbot House


  • Wages,
  • tips,
  • salaries from all current employment (Gross Income),
  • including self-employment (income minus expenses)


  • Moneys received from sources other than employment.
  • Alimony,
  • Social Security Benefits,
  • Child Support,
  • Social Security Disability (SSDI),
  • Dividends and Interest,
  • Unemployment compensation
  • Income from Estates/Trusts,
  • VA Benefits,
  • Rental Income,
  • Veteran’s Pension,
  • Pensions and Annuities,
  • Worker’s Compensation (LVIM will not see patients forcovered injuries)

DO NOT INCLUDE: Supplemental Security Income (SSI) Food Stamps Temporary Assistance for Needy Families (TANF)