The Gold Card is a Texas public health benefit that provides subsidized medical costs. Your first step in obtaining a gold card is to call for an appointment. You may call the Harris County Hospital District’s Gold Card Hotline 713-678-1003 to schedule an interview with a gold card representative at a location nearest you.

Below are some helpful tips with regards to obtaining a Gold Card.

FINANCIAL ASSISTANCE APPLICATION INSTRUCTIONS

There is No Fee for a Gold Card. If you are asked to pay for a Gold Card, please report this to 713­566­6277.

Applying for Financial Assistance: Call (713) 566‐6509 to schedule an appointment or

Mail to:
HCHD Financial Assistance Program P.O. Box 300488
Houston, TX 77230

or Drop off to the nearest Eligibility Center
Please provide copies of the following papers

• Identification (ID) (One for you and your spouse) – State issued driver’s license, state issued ID card, current student ID with picture, current employee job badge with picture , passport with picture, U.S. Immigration documents with picture, credit card with picture, foreign consulate ID card with picture. If picture ID is not available, two of the following proofs may be used: birth certificate (not for married women), marriage license, social security card, other federal documents showing identity, hospital or birth records, adoption papers or records, voter’s registration card, current wage stubs, Medicare card or current Medicaid.
• Address – One proof of address that shows your name or your spouse’s name dated within the last 60 days:
  Utility bills, school record for children under age 18, mortgage coupon, credit card statement, printout from IRS of most current year’s tax filing, certification documents or benefit checks from Social Security Administration or Texas Workforce Commission, certification documents from SNAP (Supplemental Nutrition Assistance Program, formerly known as food stamp), Medicaid or Medicare, letter from recognized social services agency, business mail, statement from a licensed child care provider, Harris County Hospital District Residence Verification Form completed by a reliable person not living in the same household or Harris County Hospital District Rental Verification Form completed by landlord.
  OR
  One proof of address that shows your name or your spouse’s name dated within the past year:
  Current lease agreements, department of motor vehicles record, property tax documents, automobile insurance documents (non expired), automobile registration or voter’s registration card for current year.
• Income for the past 30 days of each household member – Current check stubs, child supports, current IRS 1040 tax return, Harris County Hospital District Statement of Self Employment Income Form, Harris County Hospital District Wage Verification Form, Social Security, Retirement or Veteran Affairs letter or check, unemployment benefit records or Harris County Hospital District Statement of Support Form if no income.
• Household members (one for each) – Birth certificate, baptismal record, proof of full time school enrollment for students aged 18 to 23, Social Security Award letter with dependent’s names, school documents or insurance documents showing names of parent and child, U.S. Immigration applications with dependents’ names, divorce or child support decree, baby’s Popras form, birth fact record or hospital armband for infants under 90 days old, current Medicaid or Death Certificate for previous household members.
• Immigration Status (for each household member) – You must bring documents from the U.S. Citizenship and Immigration Services.
• Health Care Coverage (for each household member) – Please bring current proof of Medicaid, CHIP, CHIP Perinatal, Medicare or health insurance.
• Resources for Medicare patients – You must provide proof of your resources and liabilities (current bank statement, credit card bills, loans, etc.) on a Medicare Asset Form.

*You must apply for CHIP, CHIP Perinatal, Medicaid, TANF (Temporary Assistance for Needy Families) or SSI (Supplemental Security Income) benefits if you qualify.

If you need help getting proof, the interviewer can help you.