How TO BECOME A PATIENT

ENROLLMENT

More than half of our patients are in fact employed - but often their job, or jobs, are part-time, and if their employer does offer health insurance, they can’t afford the premiums and co-pays. The remaining patients have lacked consistent access to healthcare causing standard screening and/or preventable treatments to go unaddressed – in many instances resulting in more serious medical issues.

 

If the high cost makes health insurance and health care out of your reach, the Gloucester Mathews Care Clinic may be able to help.  The Clinic has recently expanded its eligibility criteria to ensure access to care for those who don’t qualify for Medicaid, but can’t afford health insurance.

apply

online

Complete the online patient application form and one of our Patient Access Specialists will reach out to you to schedule an eligibility screening appointment. 

apply

by phone

Call 804-210-1368, option 8 ext. 207  (Monday – Thursday 8:00 a.m. to 5:00 p.m. or Friday 8:00 a.m. to noon) to gather your information and schedule an eligibility screening appointment.

ELIGIBILITY

PLEASE READ CAREFULLY. To become a patient at the Gloucester Mathews Care Clinic you must be:

  • a resident of Gloucester County or Mathews County

  • 18 to 64 years of age

  • Uninsured, and not eligible for Medicaid

  • at or below the household income as stated in the charts shown;

REQUIRED DOCUMENTS

FOR A SCREENING APPOINTMENT

At your screening appointment, you must provide the following documentation for everyone listed on your latest tax return.

  1. last two months worth of pay stubs

  2. most recent 1040 tax return and;

    • a copy of any W2s, or 1099s​

    • IF SELF EMPLOYED, a copy of schedule C

  3. proof of all other form of income;

    • unemployment checks/letter of determination​* ​
      (If unemployed and not receiving unemployment benefits, you will be asked to have a friend or family member to complete the GMCC Letter of Support - which confirms you are unemployed with no income and how expenses are being met. The GMCC Letter of Support is available at the Clinic Administration Office.)

    • child support/alimony checks or court decree

    • social security/disability/widow/widowers benefits letter

    • food stamps benefits letter

    • TANF determination letter

  4. copy of drivers license or state ID

  5. proof of residence (utility bill, vehicle title, etc.)

 
GLOUCESTER MATHEWS CARE CLINIC

MAILING ADDRESS

P.O. Box 684

Gloucester, VA 23061

PHYSICAL ADDRESS

6031 Industrial Pkwy

Gloucester, VA 23061

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PLEASE NOTE: This is not a Patient Portal. Do not use this form to communicate any patient related medical or financial information.

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