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(800) 657-5177

Applying for Assistance

If you do not have insurance, have insurance but your insurance does not cover a portion of your visit, or if you do not wish to use your insurance for reasons related to confidentiality, you may be eligible for a state family planning assistance program that will cover the cost of your visit.

Essential Health Clinic staff can help you apply for an assistance program.

For more information about the Wisconsin assistance program, Family Planning Only Services (FPOS), and eligibility requirements, download our FPOS Brochure.

To apply for an assistance program you will need

  • A picture ID
  • A month's worth of your most recent pay stubs, OR a completed Employer Verification of Earnings Form for all jobs you have had in the last three months.
  • Your social security number (if you know your number, you do not need to bring your social security card)
  • If you were not born in Wisconsin, you will also need a birth certificate or passport.

To reapply for an assistance program you will need

  • A month’s worth of your most recent paycheck stubs, OR a completed Employer Verification of Earnings Form for all jobs you have had in the last three months.

Applying for the Minnesota family planning assistance program

Essential Health Clinic staff can also help you apply for the Minnesota assistance program. If you live in Minnesota, you can apply for the Minnesota Family Planning Program (MFPP).

To apply for MFPP, you will need:

  • A picture ID
  • Your social security number (if you know your number, you do not need to bring your social security card)
  • A copy of your birth certificate or passport (if you are a new enrollee)
  • A month of recent pay stubs OR a written statement of earnings from your employer
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