Prescription Assistance Program
Located at:
Van Dee Medical Building
4 Eustis Street Eustis, FL 32726
Phone: (352) 357-1668
Fax: (352) 589-0415
(Monday thru Friday 8 AM - 5 PM)
Best Little Thrift
Shop
415 Citrus Tower Boulevard Clermont, Fl. 34711
(Monday and Wednesday
1 PM - 3:30 PM)
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 80% 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 have any type of prescription insurance
What are the income limits?
|
Family Size
|
Max. Allowable Annual
Income
|
Max Allowable Monthly
Income
|
|
1
|
$16,245
|
$1,353
|
|
2
|
$21,855
|
$1,821
|
|
3
|
$27,465
|
$2,288
|
|
4
|
$33,075
|
$2,756
|
|
5
|
$38,685
|
$3,223
|
|
6
|
$44,295
|
$3,691
|
|
7
|
$49,905
|
$4,158
|
|
8
|
$55,515
|
$4,626
|
|
If your adjusted income is
equal to or less than the maximum allowable income, you may
be eligibility for assistance
|
To Apply:
Contact the Lake County Health Department Prescription Assistance
Program for more information and to schedule an appointment:
What do I need to bring when I apply?
- Driver's license/Identification Card and Social
Security for everyone in household.
- Birth Certificate or Voter's ID for applicant
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.
|
