Indigent Health Care Program

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What is CIHCP?

CIHCP is a county program that provides medically necessary health care benefits to individuals who meet the income, resource, residency, and household criteria; and who are categorically ineligible for the Texas Medicaid Program.

How Does CIHCP Help Me?

The CIHCP is like an eligibility based health plan that provides medically necessary health care benefits.

CIHCP pays for covered services. Some services require prior approval to be covered. All services must be medically necessary. You may be responsible to pay for some services if you choose to receive services that are not covered or are not considered medically necessary.

How can I access services?

Call Angleton Office (979) 864-1884 or Alvin Office (281)585-3024, to have one of our staff members mail you an application.

Come by our offices at 434 E. Mulberry in Angleton or 260 George St., Suite 200 in Alvin and pick up an application, office hours are 8AM - 12PM & 1PM - 5PM.

Print the application from this website :

Brazoria County Indigent Application - English

Brazoria County Indigent Application - Spanish


Once you have completed your application, simply mail the ORIGINAL FORMS to our office or drop them off with a copy of your driver’s license or ID. **Faxed applications will NOT be accepted.

(*Please note: the address you list on the application must match the address on your Texas driver’s license or Texas Id.)

For persons that receive assistance (money, financial assistance, housing, etc.) from another individual, you must complete the management verification form located below.

Management Verification Form:

Management Verification Form - English

Management Verification Form Spanish

 Please print and have notarized before your appointment. 


 Billing Provider Information:

Fax notification is required within 72 hours of onset of emergency visit and/or admission. Please fax Face Sheet to (979) 864-3922.

 Billing Address: Brazoria County Indigent Health Program

Attention: Jennifer Gutierrez

434 E. Mulberry

Angleton, Texas 77515

Please email Billing Inquiries to


Claim Status Request Form


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