{"id":645,"date":"2024-03-21T12:19:01","date_gmt":"2024-03-21T16:19:01","guid":{"rendered":"https:\/\/www.vdh.virginia.gov\/norfolk\/?page_id=645"},"modified":"2024-03-21T12:19:01","modified_gmt":"2024-03-21T16:19:01","slug":"clinic-eligibility-and-fees","status":"publish","type":"page","link":"https:\/\/www.vdh.virginia.gov\/norfolk\/clinic-eligibility-and-fees\/","title":{"rendered":"Clinic Eligibility and Fees"},"content":{"rendered":"
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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tClinic Eligibility\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t
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Clinic Eligibility<\/h2>\n

Eligibility requirements vary depending on the service provided. Some services are free, some are a flat fee and others have a fee based on a sliding scale. Sliding scale means that in general, the more income you have, the larger the fee you pay for services. Financial eligibility is determined annually and whenever there is a change in financial status. You must have identification and proof of income when services are provided. Click below to view what documents are acceptable for proof of identification and income.<\/h4>\n

Proof of Identification<\/h4>\n

Infant\/Child:<\/h4>\n
    \n
  • Birth Certificate<\/li>\n
  • Passport\/Visa<\/li>\n
  • Medical\/hospital record<\/li>\n
  • Hospital\/clinic record<\/li>\n
  • Social Security card<\/li>\n
  • AFDC\/Welfare Photo ID<\/li>\n
  • Proof that mother is on WIC (WIC ID Folder)<\/li>\n<\/ul>\n

    Adults:<\/h4>\n
      \n
    • Birth Certificate<\/li>\n
    • Driver's License<\/li>\n
    • Passport\/Visa<\/li>\n
    • Immigration or Naturalization Record<\/li>\n
    • Marriage certificate\/license<\/li>\n
    • Medical\/Hospital record or chart<\/li>\n
    • Hospital\/clinic ID card<\/li>\n
    • School records<\/li>\n
    • Military records\/Military ID\/Military Discharge papers<\/li>\n
    • Social Security card<\/li>\n
    • AFDC\/Welfare photo ID or copy of letter from Social Services stating amount of AFDC payments<\/li>\n
    • Valid Medicaid Card<\/li>\n<\/ul>\n

      Proof of Income includes but not limited to the following:<\/h3>\n
        \n
      • Pay Stubs - provide either the most recent with \"Year to date\" income listed<\/li>\n
      • W-2 Form or income tax return for most current calendar year<\/li>\n
      • Unemployment notice from VEC (Virginia Employment Commission)<\/li>\n
      • Statement of Social Security benefits or other benefits<\/li>\n
      • Military LES (leave and earning statement) (WIC Program Only)<\/li>\n
      • Foster care statement from Social Services<\/li>\n
      • Food stamps - Letter of eligibility (WIC Program Only)<\/li>\n
      • AFDC check stub (WIC Program Only)<\/li>\n
      • Medicaid card for current month<\/li>\n
      • Free or reduced school lunch - letter of eligibility (WIC and Dental (for free) Programs Only)<\/li>\n<\/ul>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t
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        Flat Fee Services:<\/h3>\n
          \n
        • Tuberculin testing for adults<\/li>\n
        • Routine Adult Immunizations - based on cost of vaccine plus administrative fees<\/li>\n
        • Call for further information<\/li>\n<\/ul>\n

          Free Services:<\/h3>\n
            \n
          • Investigation of Communicable Diseases<\/li>\n
          • Identification and testing of contacts of Tuberculosis cases<\/li>\n
          • Required Childhood Immunizations (birth up to nineteenth birthday.)<\/li>\n<\/ul>\n

            Sliding Scale Services:<\/h3>\n
              \n
            • Family Planning Services<\/li>\n
            • Maternity Services<\/li>\n
            • Pediatric Services<\/li>\n
            • Treatment of Tuberculosis<\/li>\n
            • Dental Services (free to children in school lunch program)<\/li>\n<\/ul>\n

              Sliding Scale Guidelines:<\/h3>\n

              Based on client income, payment will be full fee, 95% (of full fee), 75%, 50%, 25%, 10% or free.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
              Family Size<\/strong><\/td>\nFree if less than:<\/strong><\/td>\nFull Fee if above:<\/strong><\/td>\n<\/tr>\n
              1<\/td>\n$12,880<\/td>\n$32,201<\/td>\n<\/tr>\n
              2<\/td>\n$17,420<\/td>\n$43,551<\/td>\n<\/tr>\n
              3<\/td>\n$21,960<\/td>\n$54,901<\/td>\n<\/tr>\n
              4<\/td>\n$26500<\/td>\n$66,251<\/td>\n<\/tr>\n
              5<\/td>\n$31,040<\/td>\n$77,601<\/td>\n<\/tr>\n
              6<\/td>\n$35,580<\/td>\n$88,951<\/td>\n<\/tr>\n
              7<\/td>\n$40,120<\/td>\n$100,301<\/td>\n<\/tr>\n
              8<\/td>\n$44,660<\/td>\n$111,651<\/td>\n<\/tr>\n
              9<\/td>\n$49,200<\/td>\n$123,001<\/td>\n<\/tr>\n
              10<\/td>\n$53,740<\/td>\n$134,351<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"

              Clinic Eligibility Clinic Eligibility Eligibility requirements vary depending on the service provided. Some services are free, some are a flat fee and others have a fee based on a sliding scale. Sliding scale means that in general, the more income you have, the larger the fee you pay for services. Financial eligibility is determined annually […]<\/p>\n","protected":false},"author":611,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"tags":[],"class_list":["post-645","page","type-page","status-publish","hentry"],"yoast_head":"\nClinic Eligibility and Fees - Norfolk Health Department<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.vdh.virginia.gov\/norfolk\/clinic-eligibility-and-fees\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Clinic Eligibility and Fees - Norfolk Health Department\" \/>\n<meta property=\"og:description\" content=\"Clinic Eligibility Clinic Eligibility Eligibility requirements vary depending on the service provided. 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