You can always press Enter⏎ to continue
Health Access Eligibility Quiz
Take this short quiz to see if you may be eligible for services at Health Access.
6
Questions
START
1
Are you between the ages of 18-64?
YES
NO
Previous
Next
Submit
Press
Enter
2
Do you live in any of the following counties?
Harrison or Doddridge
Barbour/ Ritchie/ Lewis
Other
Previous
Next
Submit
Press
Enter
3
What is your insurance status?
No Health Insurance
WV Medicaid
Private Insurance
Medicare (Part A Only)
Medicare
Marketplace Plan
Previous
Next
Submit
Press
Enter
4
Are you at or below 250% of FPL?
Click here to calculate your FPL.
https://www.needymeds.org/federal-poverty-level-calculator
YES
NO
Previous
Next
Submit
Press
Enter
5
Name
First Name
Last Name
Previous
Next
Submit
Press
Enter
6
Phone Number
Area Code
Phone Number
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
6
See All
Go Back
Submit