How to Enroll in HealthPAC

Follow these steps to apply for HealthPAC:

• Call a site listed under “Where to Apply.” Ask for an appointment to apply for HealthPAC.
• Bring proof of your identity, residence, and income (one each).
• At your appointment an assistor will help you apply and answer your questions about HealthPAC.
• If your application is approved, you will receive a HealthPAC ID card.

What to bring when you apply

Please present one form of proof from each group below:
 

Proof of Identity

• Recent and valid California driver’s license
• ID card issued by the Department of Motor Vehicles
• Voter’s Registration Card from another country which has picture, name, and birth date
• Consular ID with photo
• School ID card with photo
• Work badge, building pass with photo

Proof of Alameda County Residency

• Current, valid California vehicle registration in your/your family’s name
• Recent receipt for rent or mortgage in Alameda County
• Recent utility bill in your family’s name
• Recent bank statement with home address
• Letter of support from a person you stay with, along with a utility bill in their name
• Declaration signed under penalty of perjury that proof is not available

Proof of Income

• Recent check stub from any of these sources: paycheck, unemployment, disability, or Worker’s Compensation
• Award letter stating the amount of benefits received, including pension, Social Security, VA, State Unemployment, or Disability award
• Statement from providers of other income (contributions, refunds, child support, etc.)
• Self-employment information: last year’s Income tax return or current 3-month Profit and Loss Statement
• Declaration signed under penalty of perjury regarding cash income, with payment amount and frequency of pay