Eligibility & Fees New Patient Forms

Eligibility

MEHOP is an In-Network provider for many insurance carriers. For patients who do not have medical or dental insurance or who's benefits are limited, MEHOP provides healthcare services based on a sliding fee scale which allows patients to receive services at discounted fees. Our sliding fee scale is based on household income and family size. For example, if a family of four earns $44, 700 or less in annual household income they would qualify for one of our sliding fee scales.

New patients who do not have medical or dental insurance or who's benefits are limited will need to schedule an appointment with our eligibility department prior to seeing one of our providers. During your appointment with eligibility, we will require the following information in order to ensure proper placement on our sliding fee scale. The appointment with eligibility takes approximately 15 minutes. Once established, eligibility is valid for 6 months. and will need to be updated after time period expires.

Please bring the following to your eligibility appointment:

Proof of income for household
- Current Tax Return, 3 Pay Stubs, Unemployment verification, Social Security Award Letter, SNAP verification, ect.
Utility bill for address verification
Verification of those living in household

For information or Eligibility regarding the indigent program for Matagorda County (MAP program) please visit http://www.matagordaregional.org/public-health-clinic/ or contact the Public Health Clinic at 979-244-8136. For information on the indigent program for Wharton County, please ask for assistance from MEHOP Eligibility Personnel.

Fees

Services at MEHOP are not free. If a patient has insurance, their carrier will be billed according to services provided. If a patient is uninsured, MEHOP offers services on a sliding fee scale which provides discounted fees for services. In order to determine which sliding scale a patient is eligible for, the patient must first meet with our Eligibility Department. Once the appropriate sliding scale has been established, patients are provided with the general fees associated with services. Payment is expected at time of service.