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Eligibility Calculator
Eligibility Calculator
Applicant Zip Code
Household Size
Older Adults Ages (comma-separated)
Children Ages (comma-separated)
Weekly Work Hours
Gross Yearly Household Income
Gross Monthly Household Income
Medicare Part A Credits
Assets\Resources
Pregnant
Yes
No
Diabetic
Yes
No
Brain\Spinal Injury
Yes
No
Military Affiliation
Yes
No
Genetic Disorder
Yes
No
Disabled
Yes
No
Postpartum Period
Yes
No
Life Limiting Illness
Yes
No
Breast\Cervical Cancer
Yes
No
Reproductive Health Needs
Yes
No
Blind
Yes
No
Mood Disorder
Yes
No
Has Vehicle
Yes
No
HIV/AIDS Diagnosis
Yes
No
Substance Use Disorder
Yes
No
Student Status
Yes
No
Participation in Research
Yes
No
Rehabilitation Need
Yes
No
Foster Care
Yes
No
Tribal Membership\Urban Indian
Yes
No
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Eligibility Calculator
How to Use
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Example:
Please use this as an example. Replace the fields with your own data.
My ZIP code is 07001. The household consists of three members, earning $5000 per month, which corresponds to $12000 per year. My household possess assets worth $1000. There are older adults aged 36 and 70, and a child aged 4. We work a total of 21 hours per week. We have 29 Medicare Part A credits. No one is pregnant, disabled, blind, or a student.
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