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Assistance Forms

Midwest Eye Care provides free and reduced-cost care for patients who have a demonstrated financial need. In addition to patients who contact us directly, we also work closely with the One World Community Health Center and the Hope Medical Outreach Coalition to provide eye care to patients who otherwise could not afford it.

In order for a patient to demonstrate that they qualify for free or reduced-cost care, Midwest Eye Care requires patients to submit financial information, including a listing of assets, debts, income and expenses. Links for the required forms:

Financial questionnaire – English

Questionario de finanzas – Espanol

In addition to our charitable work throughout the year, we also set aside one day of surgery each May to provide free cataract surgery to 25 individuals who otherwise could not afford it. Since 1995, we have provided free cataract surgery to over 200 individuals through the Mission Cataract program. Mission Cataract is solely for patients without Medicare, Medicaid, health insurance or the means to pay for surgery themselves. Each March we solicit referrals from local doctors and charitable organizations. Candidates are given a free eye exam, and from those candidates twenty-five individuals are selected for free surgery. The surgeon, surgery center, anesthetist and pre-op doctor all provide their services at no cost.

If you or someone you know may be a candidate for Mission Cataract, please call our office at 402-552-2020 and ask to have their name added to our candidate list. Mission Cataract is held in May of each year.

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