Necessary Documents to Enroll
During your application appointment, you will be required to provide the following documentation:
- Personal identification
- Proof of San Francisco residency
- Proof of household income and assets
This documentation helps the Application Assistor determine if you are eligible for Healthy San Francisco or for another public health insurance program. Your application will be considered incomplete until all required documents are submitted.
1. Personal Identification: ONLY ONE of the following documents is needed. Your personal identification must contain a photograph. For Example:
2. Proof of Residency: ONLY ONE of the following documents is needed. Your proof of residency must show your name.
Affidavit of Support – This is a form that someone you live with can sign to vouch for your residency. They will need to provide one of the listed items in their name. (Click here to download the form)
Individuals living temporarily in San Francisco on an active visa (student visa or tourist visa) are not eligible for Healthy San Francisco.
3. Proof of Income. For EACH member of the household, please provide the most recent copy of one of the following documents as proof of income.
If you are self-employed or own a small business and do not have a current tax return, you may use a Profit and Loss Statement to document your income.
4. Proof of Assets. For EACH member of the household, please provide the most recent copy of one of the following documents as proof of assets.
*Additional documentation may be required.