Charity Care &
I Want To
Express Enrollment Van
Enrollment Specialists need certain documents to properly screen you and your family for charity care and financial assistance programs. Without the required documents, we will not be able to process your application.
There are several documents that can be used for each requirement and documents that are acceptable for one program may not apply to all. We recommend that you bring the document that can be used for every program, if possible.
Please bring proof of the following required items to every appointment.
Proof of Identity and Lawful Presence is required for every applicant age 18 or older for all programs.
Proof of Citizenship, Lawful Presence, and Residency Status
Proof of Homelessness
(only if Applying for the Z Rate in CICP)
Other Required Documentation - Providing additional documents is required for some programs.
Proof of Identity & Lawful Presence
Valid Colorado Driver's License
Valid Colorado ID Card
Driver's License of government-issued photo ID from any state in the U.S.
Driver's license or government-issued ID from certain U.S. States (contact us)
U.S. Military ID Card or Military Dependents ID
US Coast Guard Merchant Mariner Care
Native American Tribal Document
Certificate of Naturalization (DHS forms N-550 or N-570)
Certificate of US Citizenship (DHS forms N-560 or N-561)
Military Dependent's ID Card, if it has a photo
School/University photo ID card (SMILES card not accepted for Medicaid)
Credit Card with Photo ID
Non-US Passport/Immigration Card
Employment Photo ID Card with Employer Information
Photo ID card from CostCO/Price Club, etc.
Photo from Denver Recreation Center
Marriage License (if it has a photo)
Foreign consulate photo ID card
Foreign Electoral/Voter Photo ID Card
Birth certificate for minor child
Adoption papers for minor child
For children under 18: Affidavit of ID acceptable if no other ID is available
Proof of Citizenship, Lawful Presence & Residency Status
Required for all family members:
Proof of Income
Pay stubs from previous/current month of work. Should have at least one month of consecutive pay stubs.
If no pay stubs are available, then bring a typed letter from your employer on company letterhead showing gross income for previous and current month, how long you have been employed there, actual hours worked per week, pay per hour and pay frequency. (You may also use our employment letter to provide income information.)
If you are self-employed, bring your business ledgers,mileage sheet(s) and business expenses for the previous and current month.
If you have unearned income, you must know the monthly amount. (To apply for Medicare Savings Programs, you must bring your Social Security Notice of Award showing your monthly income amount.)
Proof of Denver County Address
If the applicant or his/her spouse owns or leases a residence in Denver County, the applicant must present one of the following:
Proof of Homelessness
Documentation of the value of your assets, i.e. bank statements, Motor Vehicle registrations, and real estate records.
Health insurance cards, including Medicaid, CHP+, and commercial insurance, for all family members, if any
Denver Health cards for CICP, DFAP/Sliding Fee Scale, if any
One month of receipts for child care, elderly care, child support, and alimony paid. These items may be used as deductions.
Bills or receipts for health care costs incurred in the last year that have not been covered by insurance or a health program. These may be used as deductions.
Divorce or separation decree or court-stamped request for divorce or separation.