The Polk HealthCare Plan connects qualifying Polk County residents with essential medical services through a local network of 800 licensed healthcare providers. | Courtesy of the Polk HealthCare Plan
5-minute read

Fifteen percent of residents in Polk County under 65 are uninsured, according to the United Community Indicators. These residents — the retail cashier, the dental assistant, the warehouse associate — are classified as ALICE: asset limited, income constrained, employed. They work hard and earn a paycheck yet still struggle to cover the rising cost of living.

As a result, many often go without healthcare coverage, according to Polk County Health and Human Services Administrator Joy Johnson. They assume their income is too high to qualify for assistance programs and self‑select out, not wanting to “waste time” on an application they’re sure will be denied, especially if gathering documentation feels overwhelming. 

These individuals and families often don’t ask for help until a crisis arises, Johnson said. Facing a new diagnosis, a flare of a chronic condition, or a sudden medical bill, they finally look for options.

That’s when some find the Polk HealthCare Plan (PHP), which connects qualifying Polk County residents with essential medical services through a local network of 800 licensed healthcare providers. 

Now, county commissioners and PHP administrators like Johnson are taking steps to increase awareness and enrollment in the program before a crisis hits.

Meeting the current need

On July 21, the Polk County Board of County Commissioners voted to raise the income cap for the PHP from two times (200%) to three times (300%) the federal poverty level, while also streamlining the application process. 

“This increase in the maximum income limit is an effort to adapt to the evolving socioeconomic conditions impacting residents in Polk County,” said Johnson in a recent press release about the changes. 

According to Johnson, despite the anticipated increase in minimum wage this September, more Polk County residents risk falling through the cracks due to rising living costs, inflation, Medicaid changes, and the recent expiration of Affordable Care Act (ACA) marketplace subsidies. 

“As these changes occur, and as the federal poverty guidelines adjust each year, we are trying to account for that too. We want to make sure that we continue serving people who have a need,” said Johnson.

How policy changes expand access for working families

Because of the way that “eligibility requirements” and “application processes” can be perceived, people often assume they won’t qualify for the PHP. But with the new changes, even more working individuals and families now qualify.

Here are just a few scenarios:

Previously, the county served an average of 5,500 people a month. After the change, they expect that number to increase by around 36%, bringing the total served to approximately 7,500 people on a monthly basis, including individuals who may only participate temporarily while waiting to qualify for other programs.

Johnson said the program can to continue to adapt to meet the needs of the community. “If we need to look at adjusting that down the road, we can do that again,” she said. “If we need to increase it more, we can. If we need to reduce it, we can do that.”

“The key here is that because this program is local, it’s local administered, locally governed, local oversight. It’s not insurance, so it’s not a Medicaid program or an ACA marketplace program. It’s simply a local healthcare safety net program.”

Reducing barriers

The county anticipates that revised eligibility and documentation requirements — proof of income (one month of pay stubs or a most recent tax return) and basic demographic documentation — will remove barriers to preventative care and medical and specialist providers. 

PHP administrators are also working to reduce barriers by hosting or attending local outreach events, taking healthcare on the road around the county.

“We also have a mobile unit,” said Johnson. “We partner with the health department right now for a nurse and RN to accompany us at different locations throughout the county to provide some preventive screenings, just as a point of contact and interaction with people who may not have had a health screening before.”

“What we’re trying to do is instead of expecting and waiting for people to come to us where we are, go to them, go to them where they are in the community where there’s limited resources, limited access, and by virtue of that repetitive engagement in those locations, we want to build trust.”

Covered care and plan benefits

The PHP provides residents with essential care throughout Polk County.

  • Covered care: Primary, specialty, dental, behavioral health, urgent, emergency care; ancillary services (such as labs and diagnostics); and prescription services 
  • Additional benefits: Membership to the YMCA, transportation for healthcare-related purposes, and nutrition and healthy living classes
  • Minimal or no fees: No monthly premiums, enrollment fees, annual deductibles, or claim forms; minimal co-pays (up to $5 for non-emergency services and $25 for emergency room visits)

The PHP is not commercial insurance. It is managed by the Community Health Care section of Polk County’s Health and Human Services Division. The plan is sustained by Polk County’s voter-approved half-cent sales surtax.

How to Apply

Access the application through the Getting Started section of the PHP website.

What documents do I need?

Any one of the following documents will meet the requirement for proof of income:

  • Pay stub(s) (one month of pay stubs)
  • Previous year’s tax return
  • Social Security Statement

Any one of the following documents will meet the requirement for proof of residency:

  • Florida-issued driver license or photo ID card
  • Federal or State agency Award Letter/Check
  • Lexis Nexis Report
  • Proof of homestead ownership/purchase
  • Shelter/Residential Facility Letter
  • Utility bill (electric, water, gas bill)
  • Vehicle Registration

All applicants are also required to show a valid, U.S. government-issued photo I.D.

PHP case managers are available to provide application assistance or answer questions. Call Polk HealthCare Plan customer service at (863)533-1111 for help finding the case manager nearest you, or check out their In The Community Calendar.

Insight Polk examines community conditions and solutions in six target areas from UCIndicators.org: economic & employment opportunity, education, housing, food security, transportation & infrastructure, and quality of life.

LkldNow’s Insight Polk independent reporting is made possible by the United Community Indicators Project with funding by GiveWell Community Foundation & United Way of Central Florida. All editorial decisions are made by LkldNow.

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Sarah is a Mulberry-based freelance writer and reporter for LkldNow, where she covers education news and community initiatives across Polk County. A resident of the area for 25 years, her work is informed by a diverse background that includes a decade in higher education, research, and academic publishing, alongside her current roles as a K-2 ESE educator and an advanced yoga teacher.

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