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We provide medical and dental care to people and families who:

  • live in Montgomery County, Indiana;
  • earn income below Federal Income Guidelines (Click on Eligibility Guidelines button below)
  • do not have health insurance, Medicaid/HIP 2.0, or Medicare

If you think you qualify, this is how you apply:

  • Complete an online application (click here for English and here for Espanol) or visit the Clinic for a paper form.
  • Complete a Medical Health Questionnaire, which can be downloaded (click here for English and here for Espanol) or completed at the Clinic.
  • Gather all required documents listed on the Eligibility Guidelines below and then visit the Clinic during normal business hours.

All applications will be processed on a case by case basis. If you are unsure of your eligibility, please fill out an application and stop by the Clinic to speak with our staff. The Montgomery County Free Clinic does not discriminate based on immigration status or other personal characteristics.

If applying online:

  • Once online application is completed, we will email further instructions to the email address you provided.

If applying in person:

  • Visit the Clinic to ask for a paper application. When you come, please bring one form of picture identification, one proof of residency, and one proof of household income, as listed on page 2 of the Eligibility Guidelines above.

What are the income guidelines for eligibility?

Every year the US Department of Health and Human Services determines the definition of poverty level.   Click on the English or Spanish guidelines above for income levels.

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