212 Ninth Street
Pittsburgh, PA 15222
412-456-6910

9:00am - 4:00pm
Monday - Friday


Catholic Charities Free Health Care Center
Applying for Services

The Catholic Charities Free Health Care Center provides free, quality primary medical and dental services, with some specialty care, to uninsured and underinsured individuals of greater Pittsburgh who meet our eligibility requirements.

  • We do not discriminate based on religious beliefs, race, gender, ethnicity, age, or physical disability.
  • We provide only health services. We are not a form of health insurance coverage.
  • We are not a walk-in clinic. Volunteer doctors and dentists are only available by scheduled appointment.
  • We do not treat children under the age of 19.
    In Pennsylvania, children are covered by the Children's Health Insurance Program (CHIP)

Eligibility Requirements

You may qualify for care if you meet the following criteria. Eligibility is reevaluated annually.

  1. You have no coverage under any health insurance plan for the service for which you are applying, AND
  2. You have no coverage under Medicaid, Medicare or other government supported programs for the services for which you are applying, OR
  3. You have health insurance, but you cannot afford out-of-pocket costs such as copayments and deductibles, AND
  4. Your household income does not exceed 250% of the poverty level, based on the Federal Poverty Guideline (see below).

2016 Federal Poverty Guidelines (FPG)

The chart below shows maximum household incomes by specified time periods, which are no greater than 250% of Federal Poverty Guidelines.

Note: Household income includes all individuals that reside in the home who contribute to the annual gross income, before taxes.

Size of Family 250%
Annual Income
250%
Weekly Income
1 $29,700 $571
2 $40,050 $770
3 $50,400 $$969
4 $60,750 $1,168
5 $71,700 $1,367
6 $81,450 $1,566
7 $91,825 $1,766
8 $102,225 $1,966

Required Documentation

  1. Free Health Care Center Eligibility Application.   Download and print application.
  2. Medical Assistance Denial Notice.
    In order to receive a Medical Assistance Denial Notice, you must first complete the
    PA Dept of Human Services - Medical Assistance Application online, or go in person to the PA Dept of Human Services.

    A Medical Assistance Denial Notice dated within 6 months is required.
  3. Federal Tax Information
    • Most Recent Tax Return Transcript
      (for the applicant or for the individual who claims the applicant as dependent)
      OR
    • If the applicant is not required to file a tax return, submit a Verification of Non-Filing

      NOTE: The easiest way to obtain either of the two forms mentioned above is to visiting your local IRS office. Visit http://www.irs.gov/uac/Contact-Your-Local-IRS-Office-1 for help finding the location nearest you.
      If you cannot visit an office, you can obtain these by completing a 4506-T Form.

      Enter the necessary information in items 1a, 1b, 3, 4, and 9; check 6a for Tax Return Transcript or check 7 for Verification of Non-Filing. Sign and date the form and submit to the IRS. Please provide us with the form upon receipt from the IRS.

      If you need additional assistance, call the Eligibility Office at 412-456-6910.
  4. Proof of ALL Sources of Income
    Please submit the appropriate document(s) from the following list for each individual residing in the home who contributes to the household income.
    • One month of recent consecutive pay stub(s)
    • Social Security Benefits Statement
    • Unemployment Benefits Statement
    • Pension Statement
    • Child Support
    • Any other source of income

Note: If you have no income source including family income or government benefits, please submit a Declaration of No Income, provided by the CCFHCC.

Application Process and Form

Click here to download and print the Application Form

  1. Complete, sign and submit the Eligibility Application form along with all required documentation by mail, fax or in person. See below for address and fax number.
  2. A determination of your eligibility will be made normally within two weeks after we receive all your required information
  3. Once you have been notified that you are eligible, you must call and schedule an appointment.
    You are not automatically scheduled.

Location, Hours, Phone and Fax

Catholic Charities Free Health Care Center
Eligibility Office
212 Ninth Street, 2nd Floor
Pittsburgh, PA 15222

Monday through Friday
9:00 am to 4:00 pm
Note: This is not a walk-in clinic. To receive services, you must schedule an appointment.

Tel: 412-456-6910
Fax: 412-456-0128
Email: info.freecarepgh@ccpgh.org

Catholic Charities Free Health Care Center does not use email as a method of communicating personal information.
If you have a question about our services, please call 412-456-6910. Thank you.