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1. www.medicaid.gov › downloads › single-streamlined-applicationApplication for Health Coverage & Help Paying Costs -...

   www.medicaid.gov › downloads › single-streamlined-application

   Download and fill out this application to see what coverage you qualify for, such as Medicaid, CHIP, or tax credits. You can apply online, by phone, or in person, and get help with the application.

2. www.scdhhs.gov › sites › defaultApplication for Medicaid and Affordable Health Coverage - SC DHHS

   www.scdhhs.gov › sites › default

   • Use this application to apply for anyone in your family. • Apply even if you or your child already has health coverage. You could be eligible for lower-cost or free coverage.

3. www.health.ny.gov › forms › doh-4220Health Insurance - New York State Department of Health

   www.health.ny.gov › forms › doh-4220

   Download and fill out this form to apply for Medicaid, Family Planning Benefit Program, or health insurance premium assistance in New York State. The form includes instructions, confidentiality statement, and questions about your personal and family information, income, and health insurance.

4. health.wnylc.com › health › entryNYS Medicaid Application Form (updated 2021) for Age 65+ or...

   health.wnylc.com › health › entry

   • Αποθηκευμένο αντίγραφο

   17 Ιουν 2010 · Updated: 06 Feb, 2024. by Rachel Holtzman (New York Legal Assistance Group) Since 2010, the New York State Department of Health Medicaid application form is called the Access NY Application or Health Insurance Application or form DOH-4220. Download the most recent version of the form at this link.

5. ldh.la.gov › assets › medicaidApplication for Health Coverage - Louisiana Department of Health

   ldh.la.gov › assets › medicaid

   9 Σεπ 2022 · Use this application to apply for anyone in your family. Apply even if you or your child already has health coverage. You could be eligible for lower-cost or free coverage. Families that include immigrants can apply. You can apply for your child even if you aren’t eligible for coverage.

6. www.hhs.texas.gov › regulations › formsForm H1200, Application for Assistance – Your Texas Benefits

   www.hhs.texas.gov › regulations › forms

   • Αποθηκευμένο αντίγραφο

   Download and open Form H1200 to apply for Medicaid for the Elderly and People with Disabilities or Medicare Savings Program in Texas. The form is available in English and Spanish PDF formats.

7. www.nyc.gov › assets › hraHealth Insurance APPLICATION - access NY health care for Children...

   www.nyc.gov › assets › hra

   can be used to apply for Medicaid, the Family Planning Benefit Program, or for assistance paying your health insurance premiums. You can apply for yourself and/or immediate family members living with you.