Making an appointment for the Medical Clinic

Open to residents of the City of Chesapeake only. Because of the volume of patients needing care, Chesapeake Care operates BY APPOINTMENT ONLY.

To Make an Appointment (if you are NOT a current Chesapeake Care patient)

  • Call Chesapeake Care at 757-545-5700, Ext. 5004
  • You must first make an eligibility appointment to determine if you qualify for care
  • You will be told if there is a waiting list and given additional information
  • You will be called back later with a date/time and be given a list of documents to bring to your eligibility appointment
  • You will be interviewed in person to determine if you qualify for care
  • If you qualify for care, your first medical appointment may be scheduled.

You will need to bring ALL of the documents below to your eligibility appointment or you will not be able to complete your eligibility.

If you have ANY questions please  call 757-545-5700. BRING WITH YOU:

PROOF OF INCOME (all that apply)

  • Four (4) most recent pay stubs OR letter from your
    employer.

Food stamp verification (for assistance call 382-2000)

  • Unemployment letter verification (for assistance call 866-832-2363)
  • Disability verification
  • Current support/alimony
  • Proof of ANY public assistance
  • Proof of social security payments
  • Self-employed (3 mo. Bank statements personal account & business account)

IF NO INCOME:

Verification of Support
Form.  Form must   be signed prior to appointment.

LEGAL ADDRESS (Choose one)

Voter ID card

Car insurance bill

  • Utility bill

 PICTURE ID

 SOCIAL SECURITY CARD

 CURRENT FEDERAL TAX RETURN

PROCESSING FEE $20.00 CASH  OR

MONEY ORDER

You must have ALL of these items in
order to be deemed eligible for services.

Making an appointment for the Dental Center

Open to residents of Hampton Roads only. (Chesapeake, Portsmouth, Suffolk, Virginia Beach, Norfolk, Hampton, Newport News) Because of the volume of patients needing care, Chesapeake Care operates BY APPOINTMENT ONLY.

 

To Make an Appointment (if you are NOT a current Chesapeake Care patient)

  • Call Chesapeake Care at 757-545-5700 and select OPTION 2 when prompted
  • You must first make an eligibility appointment to determine if you qualify for care
  • You will be told if there is a waiting list and given additional information
  • You will be called back later with a date/time and be given a list of documents to bring to your eligibility appointment
  • You will be interviewed in person to determine if you qualify for care
  • If you qualify for dental care, your first appointment may be scheduled

 

 

 

 

 

 

 

 

 

 

 

Chesapeake Care Free Clinic has legal obligations about who is eligible for care. It is important to read and understand the eligibility requirements and to also ensure that you bring the appropriate documentation to your appointment.

Beginning June 1, 2012 we will require a current Tax Return by all of our patients. We require a 2011 1040 Tax Return.

A 4506T is no longer accepted.    We cannot renew your eligibility for another year without the 2011  1040 Tax Return. Please note that if your eligibility has expired for 90 days or more then you will become inactive.

Eligibility Requirements

You are eligible if you meet the following criteria.

1. You do not have medical insurance, Medicaid, Medicare or Virginia Benefits.

2. Your earnings are 200% or less of federal poverty guidelines (see chart below)

Number in Family200% Federal Poverty Level
  Gross Yearly Salary Gross Monthly Income* Approximate Hourly Income**
1 $22,340.00 $1,861.00 $10.74
2 $30,260.00 $2,521.00 $14.55
3 $38,180.00 $3,181.00 $18.36
4 $46,100.00 $3,841.00 $22.16
5 $54,920.00 $4,501.00 $26.40
6 $61,940.00 $5,161.00 $29.78
7 $69,860.00 $5,821.00 $33.59
8 $77,780.00 $6,481.00 $37.39
For each additional person, add:
  $7,920.00 $660.00 $3.81
* Yearly income divided by 12 Months
**Assumes a full-time job for a full year (2080 hours)

3. For medical care you must be a Chesapeake resident. Any resident of Hampton Roads may qualify for free dental services.

You will be given an appointment time to attend an eligibility clinic to pre-qualify before being scheduled for medical or dental care.  Before coming to the appointment please fill out the Eligibility Checklist and ensure that you have all documents for your appointment.

You'll be helped to complete all required paperwork such as contact information, medical history, consent form, proof of residency, income and identification. When information is complete and you meet the income, residency and insurance guidelines, you'll be scheduled for your first appointment.

If we do not have availability or you do not meet our criteria, click the Additional Resources button below for other options.

Making a Medical Appointment once you are a deemed eligible and a Chesapeake Care patient Call 545-5700 ext. 5001. If no one answers leave a message. YOUR CALL WILL BE RETURNED.

Making a Dental Appointment once you are deemed an eligible patient call 545-5700 ext.236. Please note: They are only here part time. Your call goes on a wait list and the Dental Coordinator will call you back just as soon as she has availability.

Please print and fill out this Verification of Support letter and bring it with you to your eligibility appointment.