Health Care Assistance Program (HCAP)

 

HCAP serves as the County Indigent Health Care Program for Montgomery County and is designed to provide covered healthcare services to eligible, low income residents who have no other public or private health care benefits. MCHD contracts for services with local physicians, hospitals and other providers. Please note that the HCAP program is not insurance.

 

 WHO IS ELIGIBLE?
  1. Residence – Must live in Montgomery County
  2. Income – May not exceed the minimum established Federal Poverty Income Level of 133%
  3. Resources – May not exceed $2,000 per month (or $3,000 if aged or disabled)
  4. Citizenship – US Citizens or Resident Aliens
  5. Medical Need – Must have a medical need of some kind

 

 How to apply for The Montgomery County Healthcare Assistance Program (HCAP)
  1.  Fill out the application; DO NOT leave any blanks. HCAP Application PDF
  2. To expedite your application, please attach copies of information listed below.
  3. Mail or drop off your application with required documentation attached to: HCAP – 1400 South Loop 336 West, Conroe, Texas 77304

 

 PROOF OF IDENTIFICATION (for everyone in your household)

  • Texas Driver’s License or Texas ID Card
  • Resident Alien Card or Passport
  • Social Security Card, Birth Certificate or Certificate of Naturalization
 PROOF OF RESIDENCE

  • TXDL or TXID with same address as on your application
  • Voter’s Registration Card with same address as on your application
  • Current Utility Bill showing the same address as on your application (regardless of name on bill)
 INCOME

  • Four (4) most recent paycheck stubs and the complete EMPLOYER VERIFICATION FORM (NOTE: if you have unpaid medical bills from the past 3 months, then we need all paycheck stubs for those months as well)
  • If paid in cash, you must bring a statement from your employer verifying your income
  • If self-employed, please complete the SELF-EMPLOYMENT FORM for the last 3 months and current month, also provide all expense receipts for each of the months.
  • Current Social Security Award Letter for both spouses and any children receiving it
  • Current Child Support Statements (actual checks or court-ordered child support)
  • Divorce decree or AFFIDAVIT OF SEPERATION and DOMICILE VERIFICATION FORM
  • Current verification for Workmen’s Compensation medical benefits OR denial of benefits
  • A copy of the Texas Workforce Commission Registration Form with a current date stamp
  • Current proof of any fixed income, such as: widow’s benefits, retirement, pension, dividend payments, unemployment, workmen’s compensation, etc.
RESOURCES

  • Complete bank statements from checking, savings, and business accounts
  • Verification of stocks, bonds, or retirement accounts
  • Automobile registration or title for all vehicles in the household regardless of whose name the vehicle is in (If you still owe money for the vehicle please submit the most current statement that shows the current balance)
 VERIFICATION OF OTHER ASSISTANCE

  • Current award / denial letters for TANF, SSI, Housing and Food Stamps or any other assistance program (bring all pages of those that apply)
  • Statement of Support Form completed and signed by everyone who helps to support you and a copy of the supporter(s) driver’s license/ID
 OTHER

  • If an applicant is unable to work, applicant must provide a letter or documentation from their physician stating inability and duration of inability to work

 

WHAT HAPPENS NEXT?
  • Your application and documentation will be pre-screened by a caseworker.
  • If there is any documentation needed to make a complete application, you will be notified by mail and asked to submit the additional information.
  • Once your application is complete, we will complete the pre-screen process and notify you by phone or mail to set up an appointment. (We reserve the right to request additional information at  any time during the application or interview process.)
  • Should you case be denied, you will be mailed a denial letter.

 

 

RESOURCES
 Montgomery County Indigent Care Plan Handbook
 Medical Assistance Plan Map Handbook
 HCAP Provider Directory
 MCHD Provider Information Form

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DSC_0773Health Care Assistance Program

1400 S. Loop 336 West

Conroe, Texas 77304

First floor, Suite 150

936-523-5101

HOURS:

M-Thur 7:30AM-4:30PM

Friday 7:30AM-11:30AM