How to Become a Patient

HOW TO APPLY

VMSN Eligibility pre-screening applications are available at the Ruffin Family and Paradise Park clinics or online at the bottom of this page. You must complete a pre-screening application (one per family) prior to your Eligibility interview. Eligibility interviews are conducted on a first-come, first serve basis on:

Ruffin Family Clinic,  4-8pm on Tues., and 9 am to 12 pm and 1pm to 4pm - Wed. and Fri.

Paradise Park Clinic, 3-7 pm,Tues ONLY

To be eligible: 

1). You must not have private health insurance, health insurance through an employer or health insurance through Nevada Health Link.

2). You must not  be currently enrolled in Medicaid, Medicare or Veteran’s Benefits; children must not have Nevada Checkup (for children only).
PLEASE NOTE: If you are pending Medicaid, you may be eligible for services at VMSN until Medicaid coverage is approved

3). You must have been a resident of Southern Nevada for at least three (3) months.

To qualify: 

You must provide all necessary information and meet our income guidelines. Household income must not be more than 200% of the 2015 Federal Poverty Level for all household members (if your household income is less than 138% FPL, you may be eligible for Medicaid):        

Household No.              200%istock Happy hispanic family

1 person -                   $23,760

2 persons -                 $32,040

3 persons -                 $40,320

4 persons -                 $48,600

5 persons -                 $56,880

6 persons -                 $65,160

7 persons -                 $73,460

8 persons -                 $81,780

*Add $8,320 for each addt’l person(s)

WHAT TO BRING TO YOUR INTERVIEW:

Proof of Identity

You will be asked to provide current photo identification at your Eligibility interview:
Current Nevada Driver’s license, lerner's permit, state-issued identification card, homeless ID (Clarity) Card, U.S. Passport or consular identification card AND

Proof of Address (choose two below):

  • Current utility bill with name/address; OR
  • Current correspondence from a Clark County agency; OR
  • Current correspondence from a Government agency (i.e. Social Security); OR
  • Lease agreement or mortgage statement with the address of the residence, your name and your landlord’s name and address; OR
  • Letter of residency from homeowner or landlord; OR
  • Pay stub with current home address.

Proof of Income:

Each household member must produce proofs of income, including the current year's federal tax return and/or W2s for each household member:

  • Federal tax return for the current year (2016); AND
  • Copy of the last three pay stubs from every person who works in the household; OR
  • Unemployment benefits statement and proof of payment history; OR
  • Proof of social security/disability income or retirement/pension benefits. If you have direct deposit for these checks, you must provide a bank statement; OR
  • Child support/alimony support documentation; OR
  • If you are paid in cash, your employer must provide a letter verifying your income with contact information; OR
  • If self-employed, bring a Profit and Loss statement and three of your most recent bank statements; OR
  • If living on savings, you must provide three of your most recent bank statements; OR
  • If no income, please providea letter of support from the person who provides food and shelter for you.

Required for children:

  • Birth certificate and proof of vaccination.
  • Ages 5-17: school ID.

Definitions

Household: Members of an immediate family who live in the same residence make up a household. That includes parents, sons, daughters, grandparents and children for whom the parents have legal custody.

Children living in the same household as their parents, under the age of 18, will be considered part of the household. Children who do not live with their parents may be included on an application if the parent can show that they support the child financially.

Proof of identity must be provided for each member of the household (including children) listed on your application.

Others living in the household, such as sisters, brothers, aunts, uncles or friends must apply separately. 

Individual: A single person who lives alone or resides with others but does not qualify as a member of their household.

*VMSN does not discriminate against patients on the basis of race, sex, color, age, national origin, sexual orientation or disability.
**Patients will be re-screened for Eligibility on an annual basis.

 

Eligibility Forms