Patients
- Adults - 18 years of age - 64 years of age
- Uninsured - no health insurance and are not eligible for government healthcare programs (Medicare, Medicaid, CHIP, Tricare, etc.)
- Residents of Brazos Valley:
- Brazos
- Burleson
- Grimes
- Leon
- Madison
- Robertson
- Washington
- Household income of less than: 200% of the Federal Poverty Level Guidelines
- Chronic disease management
- Diabetes
- Hyperlipidemia
- COPD
- Hypertension
- Asthma
- Depression/anxiety
- Chronic pain
- Simple, uncomplicated illnesses
- Respiratory/ear/bladder infections
- Rash
- Bronchitis
- Sore throat
- Flu symptoms
- Simple injuries not requiring X-rays – sprains and strains
- Non-surgical wound infections / suture or staple removal
- Preventative Dental Exams
- Tooth pain treatment with antibiotic
- Flu & Pneumonia Immunizations
- Preventative mammogram screening for breast cancer
- Medication assistance programs for clinic patients
- Counseling for smoking cessation, diabetes, obesity, heart disease and anticoagulation therapy
- Emergency care
- Oral surgery
- Cancer biopsy and treatment
- Prenatal care, Pregnancy testing, Gynecological
- Sexually transmitted disease testing
- Severe mental health issues
- Prescription filling for non-patients
- Completing disability or other program paperwork
Why do we have income guidelines?
- We have income and documentation requirements to help us serve you.
- Income requirements are a combination of grant and government health assistance program rules.
- Items such as Proof of Income, Tax return information and Social Security Numbers are required by the various drug companies that supply free medication through Prescription Assistance Programs (PAPs).
- If we do not have your information, it limits the types of medications we can provide and/or forces you to purchase medications from an outside pharmacy.
We are here to serve and do our best to help each patient receive comprehensive care.
To be eligible for HFA services, individuals must have a household income of less than or equal to 200% of the Federal Poverty Level
| Family Size | Annual | Monthly | Weekly |
| 1 | $31,120.00 | $2,593.33 | $598.46 |
| 2 | $42,300.00 | $3,525.00 | $813.46 |
| 3 | $53,300.00 | $4,441.67 | $1,025.00 |
| 4 | $64,300.00 | $5,358.33 | $1,236.54 |
| 5 | $75,300.00 | $6,275.00 | $1,448.08 |
| 6 | $86,300.00 | $7,191.67 | $1,659.62 |
| 7 | $97,300.00 | $8,108.33 | $1,871.15 |
| 8 | $108,300.00 | $9,025.00 | $2,082.69 |
| Each Add’l | $11,000.00 | $160.00 |
Making An Appointment
To schedule an appointment, call 979-774-4176
What to Bring
- Photo ID
- Social Security Card if available
- All current medication bottles (even if empty, prescribed somewhere else or for over the counter meds)
- Verifiable proof of household income for medication assistance
- Pay check stub, if working
- Most recent 1040 tax return
- Social Security award letter
- Proof of Medicaid, TANF or Food Stamps
- Child support letter from the Office of the Attorney General
- Unemployment benefits letter from Texas Workforce Commission
- If unemployed, letter of support from friend or family member
- Patient’s name must be stated
- Letter must be signed and dated
Patient Contributions
Our goal is to provide every patient with the best care. Thank you for your cooperation and understanding.
Information on Patient Donations & Payments
Need Help Paying?
If you are unable to afford a deposit, donation, or form fee, you may request a waiver or payment plan by completing a short form at the front desk or online.
No one is turned away due to inability to pay.
Dental Appointment Deposit
To schedule with the HFA/UT Dental Bus:
- You must be uninsured
- All forms must be completed and submitted
- A $25 non-refundable deposit is required. No appointment will be scheduled without payment.
Missed appointments or cancellations will forfeit your deposit and make you ineligible for future Dental Bus appointments.
Specialty Clinic Deposit
To schedule with a specialty clinic (Rheumatology, Orthopedics, Well-Woman, etc.), a $50 donation is required:
- Payment must be received within 1 week to confirm
- $25 refunded after your visit or applied to a follow-up
- No-shows or last-minute cancellations forfeit the donation
Missed Appointment Fees
To reschedule after a no-show or cancellation with less than 24 hours’ notice, a donation is required:
- 1 no-show = $5
- 2 no-shows = $10
- 3 no-shows = $20
- 4 no-shows = $50
- 5+ no-shows = dismissal from services
Forms
A $10 donation is requested for review of third-party forms.
- A separate appointment is required
- Bring all forms with you
- Payment is due at the appointment
- Provider participation is voluntary
Examples include:
- Social Security
- Disability
- SNAP
- Medicaid/CHIP/TANF
- Letters from provider
Note: Health For All does not complete forms requested by law offices but will do our best to assist case workers and government agencies when possible.
