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citizen or a legal resident Your total household income should be at or less than 400% of the federal poverty level (FPL) You are uninsured or have Medicare You do not have any commercial or private insurance coverage You should not be enrolled in any federal, state, or government programs such as Medicaid, Veteran Affairs (VA), or low-income subsidies If you qualify for Medicaid, you must sign the patient declaration section on the application and state that you are neither enrolled in Medicaid, nor plan to enroll in Medicaid, or are eligible for Medicaid or Medicare Extra Help