Check Eligibility – INS

Financial Assistance

"*" indicates required fields

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This field is for validation purposes and should be left unchanged.

Thanks for using our Eligibility Checker for Financial Assistance! Answer the following questions to see if you may be eligible for a discount on your ZoomCare bills.

Name*

First Last

Date of Birth

Are you the patient?*

Yes

Patient Name*

First Last

Do you have health insurance?*

Yes

Including yourself, what is the total number of family members living in your household?*

Please enter a number from 1 to 10.

What is your estimated gross MONTHLY household income?*

Please enter a number from 0 to 1000000.