Western Union Gold Card Program
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This page has information on the Harris Health Financial Assistance Program (formerly known as and commonly referred to as the Gold Card).
https://www.harrishealth.org/en/patients/access-care/eligibility-card/pages/default.aspx
The Gold Card is Harris County’s healthcare financial assistance for low-income Harris County residents. Its eligibility requirements are less stringent than Medicaid and the application process is much easier. Although patients with Gold Cards receive fewer benefits than those with traditional health insurance plans, the Gold Card is still a lifeline, making medications and clinic visits more affordable.
Benefits
Western Union reserves the right to offer promotional discounts that cannot be combined with Gold Card service fee reductions. 3 Standard message and data rates from mobile service providers may apply. 4 My WU enrollment requires e-mail or mobile number.
The degree of benefits received for Gold Card is governed by a 5-tiered system, based on income level. Homeless residents of Harris County are “Plan 0” and care is completely free (including prescription medication), provided they go to designated clinics.
Only HCHD services qualify for these benefits. As of August 15, 2010, all Gold Card paitents are asked to make a minimum payment at the time of hospital or clinic visit, except for pediatric and prenatal care visits. Payment occurs at the time a service is received, and remaining balances are billed to the patient.
| Service Fee Schedule* | Plan 1 (Co-pay) | Plan 2 (Co-pay) | 50% Self-Pay (Deposit) | 100% Self-Pay (Deposit) |
| Clinic1 | $3 | $10 | $38 | $76 |
| Dental2 | $8 | $20 | $38 | $76 |
| Per Prescription | $8 | $10 | 50% | 100% |
| Emergency Room Visit | $25 | $50 | $100 | $100 |
| Day Surgery | $25 | $75 | $1,000 | $2,500 |
| Inpatient Stay | $50 | $150 | $1,000 | $2,500 |
-Harris County Residence
Only individuals currently residing in Harris County are eligible for a Gold Card. Residence eligibility can be assessed with the following County Checker (works best with a zip code).
Visa Exceptions (Section C includes visa types eligible for Gold Card. Pegasus2 r4 promise utility for mac rebuild raid. Mostly diplomats, NATO officials, and other VIPs)
-Income Requirement
| Plan 1 | 0-100% of FPL |
| Plan 2 | 101-200% of FPL |
| 50% | 200-250% of FPL |
-Miscellaneous
The Gold Card application form is two pages (front and back). Please fill out the form with your patient. Applicants are highly encouraged to mail their forms to the eligibility office, as the entire process will be expedited, but 5 eligibility centers exist where patients can drop off forms. Patients should receive confirmation of receipt from the office within 10 days and acceptance or rejection of their application within 14 days.
Gold Cards must be renewed every 6 months
-Documentation Checklist
Helpful Documentation Checklist:English
Identification of Client and Spouse
Either 1 picture ID or 2 non-picture IDs. Anything that has the client’s name released by the government, a school, or the employer seems to work. If it does not have a picture, two different copies are required.
- Picture ID: Texas driver’s license or Texas Identification card, student ID with picture, employee job badge with picture, passport with picture, U.S. Immigration documents with picture, credit card with picture, ID issued by foreign consulates
- Non-Picture ID: Marriage license, birth certificates, Social Security card, U.S. naturalization, citizenship or other federal documents, hospital or birth records, adoption papers or records, voter’s registration card, Medicare card, Medicaid card, or wage stubs.Address
Address
1 proof of residency is required. This can be an official document or it can be a domicile verification form (English, Spanish, and Vietnamese versions) filled out and signed by someone they are unrelated to and are not living with (eg. neighbor, friend, employer, landlord).
- Accepted proofs dated within the past 60 days: Utility bill, credit card statement, mortgage statement; rental verification form, commercial mail addressed to you or your spouse, printout from Texas Workforce Commission.
- Accepted proofs dated within the past year: Lease agreement, school records for minor children, Department of Motor Vehicle documents, property tax statement, automobile insurance documents, automobile registration, printout from IRS or Social Security Administration, certification documents from Food Stamps, Medicaid, or Chip, letter from recognized social services agency, current voter’s registration card, post office records, and church records.
- Domicile Verification Form (English, Spanish, Vietnamese) completed by a reliable person not living with the client.
Household Income: Past 30 Days
To verify household income, 1 of the following documents must be submitted for each household member 18 or older. If the client does not have a wage stub or tax return, there are forms that can be filled out by their employer (which can be themselves) or the person financially supporting them.
- Official documents: Current check stubs, child supports, current IRS 1040/1040A tax return (all pages) if self-employed, Social Security, Retirement or Veteran Affairs letter or check, unemployment benefit records
- HCHD Statement of Self Employment Income Form: English, Spanish, Vietnamese
- For client who does not file income tax. Client must fill out, not the PDP.
- HCHD Wage Verification Form: English, Spanish, Vietnamese
- When client is paid by cash and personal check wages. Employer must fill out.
- HCHD Statement of Support Form: English, Spanish, Vietnamese
- If client has no income. The person financially supporting the client must fill out.
- As a new requirement for completion of HCHD Eligibility, every household member over the age of 18 must sign the Authorization to Release Confidential Unemployment Insurance Employee Records, which will allow HCHD to check TWC information.
- Form: English, Spanish
Household Composition
Immigration Status
Patient does not have to be a U.S. citizen to qualify for financial assistance. However, if patient is not a citizen and has documentation from the INS, it must be presented to determine eligibility for assistance.
Other Healthcare Coverage
Possible proof: award or claim letters; insurance policies; court document; other legal papers.
Medicare Asset Determination
A: Yes, but patients must fill out an extra form to determine their Medicare Assets so they can receive a discount on services and fees not covered by Medicare. Patients will likely receive a lower tier plan and receive fewer benefits from the Gold Card. This is because Medicaid is already very comprehensive.
Q: Are undocumented individuals eligible for a Gold Card if they meet all other requirements?
A: Yes. Download grab app. Unless they are a non-US citizen on visa in the States, they will be eligible for a Gold Card.
Useful Links and Numbers
Gold Card Eligibility Center Hotline: (713) 566-6509
Eligibility Center Locations
View Eligibility Center Locations in a larger map.
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This Credit Card is Not Available
Important Notice:This The Bancorp Bank credit card is no longer available, or we are no longer authorized by the bank to provide information about this card. We are displaying limited archived data. Some information may be incomplete, inaccurate or missing. We apologize for the inconvenience. Here are some of the most popular cards on Finance Globe:Western Union® Gold Card Visa® Prepaid Card Quick Summary:
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Please see the card issuer's terms and conditions regarding annual percentage rates.A 0% APR* is listed for this card, meaning that balances may need to be paid in full each month as charge cards specify, or there is a special program regarding payment. Due to the limited information we have about this rate, we advise you to read the offer details along with the terms and conditions in full. There is no annual fee for this card.*
Rewards:
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Credit Record Needed:
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FICO scores/credit scores are used to represent the creditworthiness of a person and may be one indicator to the credit type you are eligible for. However, a credit score alone does not guarantee or imply approval for any The Bancorp Bank product.
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Approval Rate:Currently, we have no applicant results in our system. You can be the first one to help by submitting your application results to assist other applicants before they apply for this card.
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Approval Time:
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Approval time for this offer is not listed. You should expect a final credit decision within a couple of weeks, but normally much sooner.
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