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
uninsured?*
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!
Do I have to be a US Citizen to qualify for care at LVIM?
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.
What if I don’t have one of the approved documents to prove that I live in Polk County, FL?
No problem! You can verify your residency by completing the Declaration of Domicile form.
What is considered a ‘household’?
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.
What if I have dental and / or vision insurance, but not health insurance?
LVIM can see you for medical services only.
What if I have Medicaid Share of Cost?
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
What if I don’t have paystubs?
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.
What exactly is 200% of the federal poverty level?
Please click here for a chart.
How does LVIM define ‘working’?
Working can take many forms. We accept individuals who work in the following ways:
What is the difference between Earned & Unearned Income?
EARNED INCOME:
UNEARNED INCOME:
DO NOT INCLUDE: Supplemental Security Income (SSI) Food Stamps Temporary Assistance for Needy Families (TANF)
