201 N. Breazeale Avenue | Mount Olive, NC 28365 919-658-4954 FAX 919-658-5754

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Mon-Fri:
7:30am to 6pm

Sat: 8am to 12pm
(Walk-in Only)
Limited Staff and Services

Sun:
Closed

The Medical Access Program, or “MAP”, is a grant-funded program created to assist patients who are not eligible for Medicaid or other reimbursement programs and seek financial assistance with the cost of their medical care.

Eligibility Criteria:

  • Must have no Primary Health Care (Medical) coverage and meet certain financial criteria
  • Patients are expected to make Mt. Olive Family Medicine Center (MOFMC) their “primary care home” and to use it for their primary care needs. They must meet the criteria to become an established patient of a primary care provider at MOFMC.
  • Established patients at MOFMC are eligible. Benefits include assistance with outstanding MOFMC bills to those who qualify
  • Patients must reside and/or pay income taxes in North Carolina. 
  • Please arrive with proper documentation for your MAP Application appointment.
  • Patients must bring proof of household income.

Items to Bring to Application Appointment:

  • Household Member Information
    • Names and ages of ALL individuals living in the household, including relatives and non-relatives
    • Documentation of the insurance of those individuals, if they are insured
    • Last employer and year worked for all individuals in the household
  • Proof of Income for ALL Members of Household ( One of the following for each employed member of the household)
    • Signed and dated past year’s completed tax form that was submitted to the IRS, or
    • Past year’s W-2 form(s), or
    • 3 most recent consecutive paycheck stubs, or
    • Letter(s) from employer(s) stating annualized income
  • Proof of any other income, including
    • Child support
    • Alimony
    • Unemployment
    • Social Security
    • Disability Benefits
  • If no income
    • Bring proof of expenses and how they are being paid. This can be in the form of a letter if someone is helping you financially.

Approval Information:

If you are approved, MAP will cover the majority of your medical visits. Depending on your income and the number of people in your household, you will be responsible for a copay ranging from $5.00 to $20.00. You will be informed of your copay during the application process. Copays are due at the time of service.

MAP Manager: Heather Tillman, 919-581-4961

 

For an Application Appointment, please call our Patient Advocate: Claudia Magana, 919-658-4954 ext. 1062

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