Prescription Assistance Program
Prescription assistance is available for low-income residents of Lake County. Assistance is limited to $1,200 per person, per year. A fee of $7.00 is charged per prescription, up to $21.00 per visit
How do I know if I am eligible?
To be eligible for prescription assistance, you must:
- Have an income at or below 150% of federal poverty limits, adjusted for family size and medical expenses
- Not have assets of more than $5,000 cash value (this excludes your home and one vehicle)
- Must not be receiving Medicaid
What are the income limits?
|
Family Size |
Max. Allowable
Annual Income |
Max. Allowable
Monthly Income |
|
1 |
$15,315 |
$1,276 |
|
2 |
$20,535 |
$1,711 |
|
3 |
$25,755 |
$2,146 |
|
4 |
$30,975 |
$2,581 |
|
5 |
$36,195 |
$3,016 |
|
6 |
$41,415 |
$3,451 |
|
7 |
$46,635 |
$3,886 |
|
8 |
$51,855 |
$4,321 |
| If your adjusted income is equal to or less than
the maximum allowable income, you may be eligible for assistance. |
To Apply:
Contact the Lake County Health Department Prescription Assistance Program for more information:
Located at:
Van Dee Medical Building
4 Eustis Street Eustis, FL 32726
Phone: (352) 357-1668
Fax: (352) 589-0415
What do I need to bring when I apply?
- Driver's license/Identification Card and Social Security for
everyone in household.
- Proof of household income ( recent pay stubs or S. S.) for everyone
in household.
- Proof of Lake County residency (utility bill with your name
and address).
- Your most recent statement of any benefits you receive (unemployment
compensation, any forms of public assistance, pensions, and retirement
benefits).
- Your most recent bank statements (checking accounts, savings,
or certificate of deposit).
- You’re most recent statements showing any dividend, interest,
or annuity income.
- Documentation showing recurring medical expenses not covered
by insurance (prescription medications, oxygen, physical therapy,
or other treatment).
- Original prescriptions from doctor or Prescription bottles with
RX #s and Refills remaining.
|
