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  1. • 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. • If you’re single, you may be able to use a short form. Visit HealthCare.gov. • Families that include immigrants can apply. childYou can apply for your

    • Medicaid

      Print an application: You may print an application by...

  2. Apply for Medicaid. For info on applying for Medicaid, please review the attached documents. Medicaid Application - English (PDF, 456.05 KB) Medicaid Application - Spanish (PDF, 949.13 KB) Medicaid Application - Attachment A (PDF, 163.25 KB) Medicaid Application - Attachment B (PDF, 139.29 KB)

  3. What you may need to apply. Why do we ask for this. • 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. • If you’re single, you may be able to use a short form. Visit HealthCare.gov.

  4. Use this application to apply for anyone in your family. your child already has health coverage. You could be eli. ible for lower-cost o. If you’re single, you may be able to use a short form. Visit HealthCare.gov. immigrants can apply. You can apply for your child even if you aren’t eligible for coverage. Applyin.

  5. Step 1. Fill out the application. Division . person for whom you are applying is eligible for benefits. Stamps or TANF. receive the application with your name, address, and signature on it. Community Outreach Services. For more information about Community Outreach Services, please visit our website at: http://www.dfcs.dhr.georgia.gov or call 1 ...

  6. Print an application: You may print an application by visiting sos.ga.gov. If you want a Georgia Voter Registration application mailed to you, you may call the Georgia Secretary of State’s office at 404-656-2871, call DFCS’ Customer Contact Center at 877-423-4746, or visit sos.ga.gov .

  7. You can apply by mail by calling 877-423-4746 and requesting to have forms mailed to you. Complete all forms mailed to you as directed and mail back to the Division of Family and Children Services. You may need to provide additional information or documentation.

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