Membership Requirements and Application Forms

Eligibility Requirements

The information given below will assist you in determining if you may be eligible for the program.

  • You must cooperate with the CareNet application process.
  • You must be a resident of Lucas County for at least 6 months.
  • You are not eligible for any government healthcare programs.
  • You are not eligible for or do not have any other form of health insurance coverage.
  • Household of 1 up to $23,760
  • Household of 2 up to $32,040
  • Household of 3 up to $40,320
  • Household of 4 up to $48,600
  • Household of 5 up to $56,880
  • For each additional person, add $8,320

**This is based on the 2016 HHS Federal Poverty Guidelines**


To Enroll

For individuals who already have a family physician, please contact his/her office to see if they accept CareNet. If they do, please contact CareNet at 419-842-0800 for instruction on how to complete the process.

If you currently do not have a family physician or your family physician is unable to see you as a CareNet member, please chose a primary care site from the application that best meets your needs. Call that clinic and ask to schedule a new patient appointment. You will need to take a completed application along with a photo ID and income verification with you to your new patient appointment.

To view and print CareNet primary care sites and the CareNet application, click here. Applications are available in English and Spanish.

Espanol

Para mas informacion en espanol, sobre el programa de CareNet, por favor comuiquese con la oficina de la United Way First Call for Help, o, Primera Llamade de Auxilio; al numero de telefono (419) 246-4636.

Para ver y copiar la aplicacion de CareNet por favor has click aqui. Para ver los lugares donde ofrecen los servicios primarios de CareNet has click aqui.

(Todos los documentos estan en format de Adobe, leeibles con una programa gratis llamado Adobe Acrobat Reader disponsible de http://www.adobe.com.


Prescription Medication Assistance

For information on obtaining prescription medication assistance, please click here. This will take you to a page that lists sources of assistance.

Further Information

For further information, please contact United Way’s First Call for Help at 419-246-4636 or for TTY for hearing impaired, 419-254-4601.