Verify Your Eligibility – Essential Meals

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215-248-3300

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Verify Your Eligibility
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Homepage
How it Works
Our Meals
Community
Verify Your Eligibility
Contact

Get Started!

Homepage
How it Works
Our Meals
Community
Verify Your Eligibility
Contact

Homepage
How it Works
Our Meals
Community
Verify Your Eligibility
Contact

Verify Your Eligibility

To verify your eligibility and register for new service, please fill out the form below and a member of our staff will contact you as soon as possible.

First Name

Last Name

Phone

Zip

Are you currently receiving home-delivered meals?

Yes No

If "Yes," who is your current provider?

Do you any have the following insurance?

Keystone First Community Health Choices PA Health and Wellness UPMC AmeriHealth Caritas Other Not sure

If you chose other, please put your response here

Do you have $8,000 or under in your bank account?

Yes No Other

If you chose other, please put your response here

Is your monthly income under $2,000?

Yes No Other

If you chose other, please put your response here

Do you receive any of the following?

SSI (Supplement Security Income) SNAP (Supplement Nutrition Assistance Program) Other None of the above

If you chose other, please put your response here

Meal Preferences

How did you hear about Essential Meals?

Are you interested in any of the following services? (Check all that apply)

Homecare Service Adult Daycare

By checking this box, I understand the my personal information will be used to determine if I am LTSS (Long-term services and support) eligible.

2633 W Girard Ave
Philadelphia, PA 19130
215-248-3300
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