Mid-South Guidelines good through January, 2018
This is a list of Federal Poverty Guidelines as approved by Congress
TOTAL HOUSEHOLD INCOME
BEFORE ANY DEDUCTIONS INCLUDING S.N.A.P INCOME
YOU CAN DOWNLOAD THIS FORM BY CLICKING THE PDF LINK BELOW
*For family units of more than 8 members, add $80 per week for each additional member
**For family units of more than 8 members, add $347 per month for each additional member
***For family units of more than 8 members, add $4,160 per year for each additional member
Anyone making more than this is considered OVER SCALE by the United States government guidelines, which the hospital must follow. However, the Mid-South Lions Sight and Hearing Service examines each case on an individual basis. Barring extenuating circumstances, each Lions Club should see that these guidelines are strictly met.
The hospital requires that all sponsored patients provide proof of their current income. This may be in the form of a current income tax return or a copy of the last payroll check or Social Security checks.
If the patient is a minor, they MUST be accompanied by one of the parents or a legal guardian.
The income requirement standards on this form are subject to change as government guidelines change.
Mid-South Lions Sight and Hearing Service
930 Madison Ave Suite 101
Memphis, TN 38103