Apply for Medicaid
You can get an application form from your local County Social Service Office office (in person or by mail), or electronically by clicking on one of the following links.
- If you are a pregnant woman or a member of a family with children under age 21, and you ONLY want medical coverage, you can complete the Application for Health Care Coverage (822kb pdf).
- If you want to apply for healthcare coverage and also want to apply for assistance with child care expenses, food assistance, or a TANF grant, the Application for Assistance will allow you to apply for any or all of these programs.
- If you are aged, blind, or disabled, and you ONLY want Medicaid coverage, the Medicare Savings Programs, or coverage in a basic care facility, you can complete the Health Care Application for the Elderly and Disabled.
- If you want to complete and submit an application online for healthcare, child care assistance, food assistance, or TANF, you can do so on the online application system.