Applying for
Polk healthcare plan

If you haven’t already looked at the eligibility requirements, please do so before applying. For your convenience, you may visit us in person, call to schedule an appointment or apply online.

• Walk-in to the Community Health Care administrative office located at 2135 Marshall Edwards Dr., Bartow 33830
• Schedule an in-person appointment (863) 533-1111
• Apply Online

Before your scheduled appointment or applying online, it is a good idea to locate the required documentation to ensure a quick and smooth application process. You will need to provide one proof of income and two proofs of Polk County residency to qualify for membership.

What documents do I need to apply?

Any (1) of the following documents will meet the requirement for proof of income:

• Court-ordered child support or alimony payments
• Expense records (bank/credit statement, profit and loss statement)
• Pay stub(s) (one month of pay stubs)
• PELL Grant Award Letter
• Pension documents
• Proof of rental income
• Self-employment Tax Form
• Social Security Award Letter
• Tax Return
• Unemployment Award Letter
• Verification of Earnings Form
• Workers’ Compensation

Any (2) of the following documents will meet the requirement for proof of residency:

• Driver License / State Identification Card
• Federal or State agency Award Letter / Check
• Lexis Nexis Report
• Proof of employment (Ex: Pay stub with home address listed)
• Property tax statement
• Proof of homestead ownership / purchase
• Rental verification completed by landlord
• Rent receipt / lease agreement
• Shelter/Residential Facility Letter
• Utility Bill (electric, water, gas bill)
• Vehicle Registration
• Verification of homelessness from Polk County Court Services Office
• Voter Registration Card