Eligibility is temporarily done by San José Clinic. To access the eligibility application, click here.
- To receive services at St. Verena Clinic, low-income, uninsured individuals and families must first complete an eligibility interview.
- Medicaid, Medicare, Affordable Care Act plans are also considered different types of health insurance coverage.
- Those that qualify for services will receive a patient account, providing them access to services.
Due to COVID-19, eligibility can be done over the phone with information faxed or emailed to our eligibility department.
Please, fax your paperwork to
or email it to
firstname.lastname@example.org. Someone will get back to you within
1 business day.
If you are not able to fax or send your paperwork electronically, please call our eligibility department at
1. Photo Identification
Please bring only one of the following for each adult:
- State Driver’s License or Identification Card (current or expired)
Passport or Visa
U.S. Immigration documents
Student or work ID*
Photo ID from another country
Other forms of photo identification*
*If a non-government issued ID is provided, another form of ID will need to be provided (such as birth certificate, marriage license, social security card, etc.)
Please bring all of the following for each child:
Birth Certificate or Birth Fact Record
Medicaid or CHIP ID cards
2. Proof of Household Income
Please bring all documents that you have.
One month’s worth of recent pay stubs. If you do not receive paystubs, a completed wage verification letter from employer will be accepted.
Most recent tax returns
Letter of support
Welfare benefit documents (TANF and Food Stamps)
SSI or Social Security certification documents
Unemployment documents / Worker’s compensation
Child support documents
3. Proof of Address
Any piece of mail that is delivered through the Postal Service with the patient’s name and address.
Please, feel free to call 713-490-2610 if you have any questions.