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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
The Harris Health Financial Assistance Program (Gold Card) is a Texas public health benefit provided by the Harris Health System that provides financial assistance for medical care for Harris County residents.
Harris Health Financial Assistance Program (Gold Card) Texas I.D. or drivers license stating the person lives in Harris County. Social Security Card. Citizenship(Passport or Birth Certificate) or Green Card. Proof of income (1 months check stubs) Any bills or bank statement (within 60 days) Income tax (if necessary)
The FPL varies based on household size: one person ($19,320), two people ($26,130), three people ($32,940), four people ($39,750), or five people ($46,560). If your household income exceeds 150% FPL, you can still receive medical treatment through Harris Health System but won't qualify for discounted services.
How do I renew my Harris County Gold Card? Gold Card Renewal Application To reapply you will need to complete a Harris Health application. This application is the exact same document that you completed when you first applied for Gold Card coverage.
Anyone is eligible regardless of age, income, or immigration status. You must be a Harris County resident.
What is the Harris Health Financial Assistance Program? The Harris Health Financial Assistance Program is a program that is available to Harris County residents whose gross family income, as it relates to family size, falls at or below at or below 150% of the Federal Poverty Level.
For questions call 713-566-6509 (Monday – Friday, 8am – 4pm) to speak to the Eligibility Call Center team member for any questions regarding the Harris Health Financial Assistance Program.