Health Coverage: 1-855-840-4774
Health and Human Services: 1-855-697-4347
Participating State Agencies
Please do not use the Forward, Back, Refresh or Stop buttons at the top of your browser. Using these buttons may cause an error. To move between pages, please use the Save and Next button at the bottom of the screen.
Thank you for beginning to apply. The program will save all your information through the previous screen. The information entered on the current screen will not be saved. When you return to the application, you will be asked to start from the current screen.
Are you sure you want to Exit? You can stay on the current screen by clicking "Cancel" or continue with exit by clicking "Continue."
When you click "SUBMIT APPLICATION," your application will be sent to a DHS worker for processing. Once the application is submitted, you will not be able to make changes or add information. DHS will contact you to request any missing documents and schedule an interview (if required).
Estamos atualizando nosso sistema de computador e teremos uma versão deste site traduzida en Espanhol e Português em breve. Até lá, por favor, ligue 1-855-840-4774 para perguntas de cobertura de saúde ou 1-855-679-4347 para perguntas sobre Programas de Serviços Humanos.
Estamos actualizando nuestro sistema informatico y queremos traducir este sitio al Espanol y Portugues. Hasta entonces, comuniquese al 1-855-840-4774 para preguntas sobre cobertura de Salud y para preguntas sobre otros programas de Sevicios Humanos favor de llamar al 1-855-679-4347.
Before logging off, you must re-submit your application. Please return to the application and click 'Next' through to the e-signature page and resubmit your application.
Changes made to your application during the last session have been saved but the process is not yet complete. The application must be resubmitted. Please click the button below to return to the application. Then, click "Next" throughout the application until you reach the e-signature page. Click "Submit" to resubmit your application.
Please wait while we process your request.