Foundation Members
To obtain a free membership, you must:
Provide evidence that you are uninsured or have Medi-Cal insurance but are unable to see your doctor in a timely manner.
Provide documentation that your income* is less than what is listed in the table for your family size.
*Based on income limits published by the Department of Housing and Urban Development.
If you meet the criteria, please fill out the form below and we’ll contact you.
| Persons in Family | Gross Yearly Family Income | Gross Monthly Family Income |
|---|---|---|
| 1 | $54,500 | $4,541.67 |
| 2 | $62,300 | $5,191.67 |
| 3 | $70,100 | $5,841.67 |
| 4 | $77,850 | $6,487.50 |
| 5 | $84,100 | $7,008.33 |
| 6 | $90,350 | $7,529.16 |
| 7 | $96,550 | $8,045.83 |
| 8 | $102,800 | $8,566.67 |
Become an East Bay Health Foundation Member
If you meet the criteria above, please fill out this form and we’ll contact you with next steps.
We’re honored to serve you.