Open Tuesdays, Thursdays, and Saturdays. SEE HOURS
555 E. Costilla St. | Colorado Springs, CO 80903
719-475-0972 or 719-596-4449 | clinic@openbiblemedical.org

Open Tuesdays, Thursdays, and Saturdays. SEE HOURS
555 E. Costilla St. | Colorado Springs, CO 80903
719-475-0972 or 719-596-4449 | clinic@openbiblemedical.org

Eligibility Guidelines

If you reside In El Paso or Teller County, Colorado and are uninsured... WE ARE HERE FOR YOU!

Our Community Pharmacy dispenses free prescription medication to our neighbors who are uninsured. You can qualify for our services if you are at or below 200% of the Federal Poverty Level.

 

Patients MUST MEET ALL of the following requirements in order to be served.

3 Steps to Qualify

Our Pharmacy helps provide medication to low income adults in Colorado Springs

Call to schedule an appointment during our normal hours to determine eligibility and provide required documentation.

Our Pharmacy helps provide medication to low income adults in Colorado Springs

Bring in required documentation and the annual registration fee.
$15.00 per individual, $25 per family.

Our Pharmacy helps provide medication to low income adults in Colorado Springs

Make your appointment and/or bring in your prescription to be filled during our normal business hours.

You Qualify if You Are

  • OVER the age of 18 and under 64
  • A veteran with NO benefits
  • Currently employed and earn LESS than or equal to 200% of the Federal Government Poverty Level Guidelines (see chart below)
  • Have NO health insurance coverage
  • NOT enrolled for state or federal coverage
    (Medicaid or Medicare)
  • NOT a member of PVCHC (Peak Vista Community Health Center)

You DO NOT Qualify if You Are

  • UNDER the age of 18 or over 64
  • A veteran with benefits
  • Currently employed and earn MORE than 200% of the Federal Government Poverty Level Guidelines (see chart below)
  • Have health insurance coverage
  • Enrolled in state or federal coverage
    (Medicaid or Medicare)
  • A member of PVCHC (Peak Vista Community Health Center)

2017 Federal Poverty Level Guidelines

You must be actively employed and earn less than or equal to the amount specified for you family size to be eligible for our clinic.

Family Size 200% Guideline
1 $24,120
2 $32,480
3 $40,840
4 $49,200
5 $57,560
6 $65,920
7 $74,280
8 $82,640

Documentation Requirements

  1. Photo Identification
  2. Proof of residency in El Paso or Teller Counties
    • Lease and most recent Utility Bill
  3. Proof of Income
    • Mandatory Items (if applicable)
      • Income Tax Forms are required (if you’ve filed) / previous year W-2 (if you’ve worked & not yet filed)
      • Disability letter from Social Security Administration (if you are receiving disability)
      • Food stamp letter showing the amount you receive monthly (if you are receiving this assistance)
    • If you have not filed Income Tax documents in recent years or don’t have a W-2, Please provide the following:
      • Pay Stubs from previous 2 months
      • Bank Statement for automatic deposits for 2 previous months
      • Unemployment Compensation Voucher