For Uninsured CrossOver Patients
How to Become a CrossOver Patient
Step one: Check your eligibility
To qualify as a new non-Medicaid patient at CrossOver, patients must have no form of insurance and have income at or below 200% of the federal poverty level. To qualify for Ryan White HIV services, patients must have income at or below 500% of the federal poverty level.
The following table shows 200% federal poverty level income limits for families of 1-5 people.
For a calculator tool to help you determine your eligibility, visit this link.
If you have Medicaid or may be eligible for Medicaid, please click here.
Step two: Apply online
Click here to apply online to become a new, uninsured CrossOver patient. Please use the menu in the upper right hand corner of the application to select English or Spanish. Once you have completed your application, you will receive a call from us within five business days.
It is preferred that you upload your proof of income documents as part of your application. If you are unable to do so, we will schedule a follow-up financial screening appointment with you. The following documents can be used for proof of income:
- tax documents for the most recent year
- pay stubs for the last two months
- letter from employer on letterhead or notarized
- letter from Social Security agency
- notarized support letter from person providing financial support
- most recent food stamp award letter
What to expect at your appointments
What to bring
- A list of any questions you have about your health. Put the questions most important to you at the top of the list. Bring this list to your appointment.
- A list of other healthcare providers you have visited. Write down their contact information and the reason for your visit.
- All of your medications, in their original containers, including prescription, over the counter, natural, and herbal medications and dietary supplements.
Cost of care
In order to sustain the high level of care CrossOver provides, we require a minimum contribution for all patient services. Below is a list of the contribution requirements. If you are unable to make this contribution, please speak to a member of the staff.
|Dental Level I – Diagnostic and Hygiene||$30-$40|
|Dental Level II – Extractions Routine or Surgical||$50-$80|
|Dental Level III – Restorative/Fillings||$60|
*Same-day visit charge must be paid even if patient has a waiver.
Amounts are subject to change.
■ If this is a medical emergency, please call 911 immediately. ■
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