757-886-0608 info@lackeyhealthcare.org

Renew Your Lackey Card

Make sure you do not let your card expire. If your card is going to expire in the next 30-60 days, submit your recertification paperwork now. It is the patient’s responsibility to have their Lackey Clinic Card renewed by the expiration date.

If Your Lackey Card Expires:

  • You cannot schedule or attend appointments
  • You cannot refill or pick up medications
  • Appointments are canceled 2 weeks prior if you have not renewed by then

Submit Your Paperwork in One of the Following Ways:

If you have questions, you can contact the Eligibility Department at 757-886-0608 ext. 252
(Se habla español: ext. 253).

Documents Required

  1. Photo ID
  2. Proof of residency such as:
    • A current bill or bank statement with recent date
    • Current lease agreement
  3. Proof of income for everyone in the household (spouses, children, parents or other family members claimed on the taxes):
    • If employed: 1 month worth of recent paystubs
    • If unemployed: Unemployment award letter
    • If no income: notarized letter of support, supporter’s proof of address (if living with supporter), and supporter’s taxes
    • If self-employed/paid in cash (files taxes): Schedule C, notarized daily earnings sheet, notarized employer letter
    • Other proof of income including statements of social security, retirement, SSI, child support, or alimony
  4. Most recent 1040 tax form if taxes were filed
  5. Signed Patient Attestation: click here to complete

Recertification Requirements

Your yearly income based on family size must be at or below the chart levels.
You must have no medical insurance or be eligible for Medicaid, Medicare, or Veterans benefits.
You must still live in our service area which includes: Newport News, Williamsburg/James City County, York County, and Poquoson.
You must be 18 years of age or older.

Questions? Contact:

Amber Martens
Director of Eligibility and Community Outreach
757-886-0608 ext. 252
enroll@lackeyhealthcare.org

Signup for Our Newsletter!

[gravityform id="2" title="false" description="false" ajax="true"]