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  1. Family-Related Medical Assistance Application. Form Approved. DCF No. CF-ES 2370, Sep 2015 [65A-1.205, F.A.C.] THINGS TO KNOW. Use this application to see what coverage choices you qualify for. • Free or low-cost insurance from Medicaid or the Children’s Health Insurance Program (CHIP)

  2. Build your Florida medicaid Application Form from the ground up with our beginner-friendly and feature-rich document editor. Start for free today!

  3. Clients can apply online for free by using the Office of Economic Self Sufficiency Self Service Portal or by visiting a DCF Community Partner. If you believe you have been charged a fee inappropriately or have suspected fraud to report, please do so here.

  4. Search Florida Department of Children and Families forms by Form Number, Form Title, Form Category, or any combination of these. Some forms require Adobe Acrobat Reader, Microsoft Word, or Microsoft Excel to open, fill in and/or print.

  5. Please note that only one application is needed, whether you apply online through the MyACCESS portal or use a paper application below. Family-Related Medicaid Application: Print and fill out this application if you are pregnant or have children who are 20 or under living with you and only want to apply for Medicaid.

  6. Some of the forms can be completed online while others will need to be printed out and mailed in. For those that can be completed online, Adobe Acrobat Reader (5.0 or higher) is required to open and fill in many of these forms.

  7. MyACCESS is a portal where Floridians can get and manage benefits online. This includes food assistance (SNAP) formerly food stamps, cash aid (TCA), and affordable health coverage (Medicaid)

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