You are eligible to become a patient of the Pain Relief Project if:
- You are on Medicare or Medicaid and (one of the following below):
- You are unemployed, on disability, or senior citizen on a fixed income
- You're Adjusted Gross Income is 100-200% of the current Federal Poverty Level (FPL)
2017 Federal Poverty Guidelines:
Use the chart below to determine if you are eligible based on FPL. Use your Household Size (yourself, your spouse, your tax-dependent children, and any other tax dependents), to see if you are eligible based on the Adjusted Gross Income (AGI) for you or your family.
If you are eligible based on your AGI, please apply online or give our office a call to help you schedule your first appointment. Our office number is (425) 686-4498, please mention you would like to schedule with our nonprofit clinic. Please bring income verification with you to your first appointment (scroll to the bottom of the page to see the list of acceptable documents).
How to Determine Adjusted Gross Income (AGI)
The AGI can be found on the following lines of your most recent tax return (round this amount to the nearest whole dollar): Form 1040 Line 38, Form 1040A Line 21, Form 1040EZ Line 4. If you are unable to locate last year's tax return, you may contact the IRS toll free at 1-800-829-1040.
How to Determine Household Size
To Determine Your Household Size: Include yourself, your spouse, children (if tax dependents), and any other tax dependents you claim for the current tax year.
What is required to verify income?
Please bring ONE of the following with you to your first appointment:
- 2017/2018 Tax Return
- 2017/2018 W2 (required from all employed individuals in the household)
- Pay stubs from all jobs (required from all employed individuals in household, valid within previous 12 months)
- Proof of current Medicaid or Medicare enrollment/ID card
- Social security benefit form
- Valid Health and Welfare work verification form (within 60 days of issue date)
- Current Unemployment/No-Work Verification Form (within 60 days of the issue date)
Not eligible or have WA state health insurance coverage for acupuncture or naturopathic medicine?
Schedule with Dr. Heintze at her private practice at Starting Point Acupuncture in Bothell, WA, call the office at (425) 686-4498 to make your first appointment.