Welcome to the LVIM Circle of Caring!

Are you looking for healthcare and don’t know where to turn?  At LVIM, we provide access to free, high-quality, comprehensive healthcare through a community of caring volunteers.  Take the next step today and see if you qualify!

Check your eligibility below, and know that even if you don’t qualify for services at LVIM, we will help you find a place that can meet your needs.

Eligibility Requirements
Let us help you determine your eligibility

Do you live in Polk County, FL?

Are you

Is your household income below 200% of the Federal Poverty Level?*

Click here to check.

Are you working, recently unemployed, or a full-time student?

Or, is anyone in your household working?

Need Assistance? Need help 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 Thursday, 8 a.m. to 4 p.m., and Fridays 8 a.m. until noon.

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 Thursday, 8 a.m. to 4 p.m., and Fridays 8 a.m. until noon.

¿No hablas Inglés? 

Estamos trabajando arduamente para que nuestro sitio web esté actualizado y disponible en español. Sin embargo, hasta que podamos, tenga en cuenta que contamos con miembros del equipo bilingües disponibles varios días a la semana y que estaremos encantados de atenderle. Para hablar con un miembro del equipo de LVIM y pedirle que le ayude a verificar su elegibilidad y completar una solicitud, llame al (863) 688-5846, extensión 104 o 105.

Los miembros de nuestro equipo de inscripción están disponibles de lunes a jueves, de 8 a. m. a 4 p. m., y los viernes, de 8 a. m. a mediodía.

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 live in Polk County, FL.

If you have a Drivers License or ID, we’ll request a copy of it; a passport or ID from your country of origin is sufficient.

However, if you do not have an ID, this will not affect your eligibility.

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

For the purposes of this application, a household is the Applicant + Partner/Spouse + Legal Dependents.

LVIM can still qualify you to receive medical services.

Depending on the levels of your coverage, you may still qualify for LVIM. Documentation may be requested.

No problem! If your place of work does not provide you with paystubs, you can complete the Verification of Earnings Form or Certification of Zero Income form.

If you are self-employed, you’ll need to submit your Schedule SE / or your most recent Profit and Loss Statement.

200% FPL in 2024

Household Size.           Maximum Annual Household Income

1                                       $30,120

2                                      $40,880

3                                      $51,640

4                                      $62,400

5                                      $73,160

Please click here for the full chart broken down by monthly income.

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
  • 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 age 18 and older
  • Residents of partner agencies: Lighthouse Ministries, Salvation Army, Talbot House


  • Wages
  • Tips
  • Salaries from all current employment (Gross Income)
  • Self-employment (income minus expenses)


  • Moneys received from sources other than employment
  • Alimony
  • Child Support
  • Social Security Retirement Benefits
  • Social Security Disability (SSDI)
  • Social Security Survivor Benefits
  • 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 for covered injuries)

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