Free Membership

In order to obtain a free membership, you must:

Provide evidence that you are uninsured (emergency Medi-Cal does not count as insurance since its scope of coverage is very limited) or have Medi-Cal insurance but are unable to see your doctor in a timely manner.
Provide documentation that your income* is less than what is listed in the table for your family size.
*Based on income limits published by the Department of Housing and Urban Development

    Persons in Family
    Gross Yearly Family Income
    Gross Monthly Family Income
  


    1
    $54,500
    $4,541.67
  

    2
    $62,300
    $5,191.67
  

    3
    $70,100
    $5,841.67
  

    4
    $77,850
    $6,487.50
  

    5
    $84,100
    $7,008.33
  

    6
    $90,350
    $7,529.16
  

    7
    $96,550
    $8,045.83
  

    8
    $102,800
    $8,566.67
  

Name

First Name

Last Name

Email

Phone

(###)

###

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If you meet the criteria above, please fill out the form below and we will contact you.