We accept the following NC Medicaid plans:

• AmeriHealth Caritas
• Carolina Complete Health
• HealthyBlue
• NC Medicaid Direct
• Trillium Health Resources
• United Healthcare Community Plan
• WellCare

📞 Call us at 910-845-5333 to verify your eligibility and schedule an appointment.

The New Hope Clinic Charity Care Program helps uninsured individuals access healthcare, including hospital financial assistance programs.

Application Process

Step 1: Complete the Eligibility Application

• Download the application:
  • [English Application Packet]
  • [Spanish Application Packet]
• No printer? Pick up a copy at:
  • 201 W Boiling Spring Rd, Southport, NC 28461
  • 3610 Express Dr, Shallotte, NC 28470 (Dropbox at The Lord's Pantry
• Or request a mailed copy by calling 910-845-5333

Step 2: Gather Required Documents

Proof of Identity (Provide 1 of the following):

• Photo ID (e.g. state-issued ID; driver’s license; other card with your photo, name and date of birth
• Permanent Resident Card (Green Card)
• Passport

Proof of Residency (Provide 2 documents with your full name and current address,
dated within the last 90 days):

• Unexpired photo ID with current address
• Utility bill, lease agreement, or bank statement
• Tax return, pay stub, or phone bill
• Benefits award/denial letter or other government-issued statement
• Call for other documents

Proof of Income (Provide all documents that apply to your situation. Must be most recent):

• One month of recent paystubs
• Two months of self-employment records
• Two months of bank statements (all accounts, all pages)
• Social Security, Disability, or Unemployment Benefits Letter
• Documents showing any other income (e.g. rental income, gifts from family
• Letter of Support (if no income)
• Last year’s tax return (Form 1040) or IRS verification of non-filing Form 4506-T (included in applicaton packet)

Proof of Uninsured Status (Provide any of the following, if applicable. We will help you figure out what is needed and how to get the letters):

• VA Benefits Denial Letter
• Medicaid Denial Letter
• Family Planning Medicaid only approval letter
• Employer Insurance Verification Form
• Private Insurance Cancellation/Termination Letter

Step 3: Submit Your Application

• Drop off or mail: 201 W Boiling Spring Rd, Southport, NC 28461
• Drop off to the dropbox outside: The Lord's Pantry, 3610 Express Dr, Shallotte, NC
• Drop off to a mobile health clinic site: view calendar
• Email: info@newhopeclinicnc.org
• Fax: 910-845-5366

Step 4: Application Review

• We’ll notify you if more information is needed.
• If you don’t hear from us in one week, please call or email.
• You will be informed of the final decision by phone or mail.

If Approved:

• Coverage lasts 90 days to 1 year based on eligibility.
• We will schedule your appointment over the phone.
• Notify the clinic within 7 days if your eligibility changes.

❌ If Denied:

• We’ll provide a list of alternative resources and help you connect with other services.