FREEMED
Application

Providing Aid to low-income individuals with no prescription insurance.

Fill out the attached form and call us at 208-528-6337 to schedule your appointment and see if you qualify for FREEMED.

Our office is open from Monday to Wednesday, 9:00AM to 02:00PM.
Download and fill out this form
Call Now

Bring the following documents to your appointment.

Identification / Citizenship Verification

Social Security Card & Driver’s License
or State ID
or Birth Certificate
or Resident Alien Papers/Card

Insurance Information (not every document may apply to you)

Current Medicaid Denial Letter 
and/or
Medical Insurance Card
or All Medicare Cards

Proof of income/Financial information

Current Federal Income Taxes
or
Current Social Security Benefit Letter
or Current Veterans Benefits
or Current Workman’s Comp. Benefits
or 3 Most Recent Paystubs
or Most Recent Bank Statement (90 days worth)
or Current Health and Welfare Benefit Letter

List of Current Medications

Bring all your current bottles/boxes with you or a pharmacy print out.

FREEMED Office

  • Open Monday through Wednesday
    9:00 a.m. to 2:00 p.m.
  • 301 S. Boulevard Suite 2 - Idaho Falls, ID 83401
  • freemedoffice@gmail.com
  • 208.528.6337
  • 208.528.6339

Message us