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Eye Help for the Public

          

Patient Eligibility


To be eligible for the program, you must submit an application with a $10 non-refundable administrative fee (PER PERSON). Cash or money order only. And you must meet the following criteria to qualify for a free eye exam and glasses:

Qualifications:
Individuals must meet the following criteria to qualify for a free eye exam and glasses:

  • The household must qualify as low income (see below).
  • The individual applying cannot have any government or private insurance that covers eye exams (IF you have Medi-Cal you DO NOT qualify).
  • The individual applying for the exam may not have had an exam in the last 2 years.

Are you considered low income?

Household
Size

Annual

Monthly Twice-
Monthly
Bi-
Weekly
Weekly
1 $21,978 $1,832 $916 $846 $423
2 $29,471 $2,470 $1,235 $1,140 $570
3 $37,296 $3,108 $1,554 $1,435 $718
4 $44,955 $3,747 $1,874 $1,730 $865
5 $52,614 $4,385 $2,193 $2,024 $1,012
6 $60,273 $5,023 $2,512 $2,319 $1,160
7 $67,951 $5,663 $2,832 $2,614 $1,307
8 $75,647 $6,304 $3,152 $2,910 $1,455
For Each
Additional Family
Member Add:
+$7,696 +$642 +$321 +$296 +$148

Effective from July 1, 2016 to June 30, 2017 (Revised 07/01/2016)

Source: www.fns.usda.gov

Request an application

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