Re-Entry Health Insurance Program
Recently released from jail or prison in the past 60 days? Complete referral form below for no cost health insurance in most cases.
First Name
Last Name
Best Contact #
Incarceration Release Date (mm/dd/yyyy)
Referred By S-DCC/VisionsClayton DCC Probation or Parole HFAF DRC/Covington Cobb DCC Other (Please enter name or organization in notes)
Notes
Website
A licensed health insurance agent will contact you shortly. PLEASE double check and make sure you entered the correct contact number. Thank you for allowing us to serve you.
Affordable Care Act (ACA) Advisors 2020
