How to Apply for CHIP – Children’s Medicaid

Apply by phone
Steps to apply by phone:

1. Call 2-1-1. That’s toll-free. When you call, pick a language and then, press 2.
2. We’ll start your application over the phone, then mail it to you for you to sign.
3. Send your application back to us with the items we need to prove your income and receipts showing what you pay for things like child care, alimony, or care for an adult who has a disability. You can use the pre-paid envelope or fax everything to 1-877-447-2839.
4. It can take up to 45 days for us to work on your application. To find out what’s happening with your application, call 2-1-1.

Apply by Mail or Fax
Steps to apply by mail or fax:

1. Get your application form. You can print an application now.
2. Send your application back to us with the items we need to prove your income (paycheck stubs) and receipts showing what you pay for things like child care, child support, or care for an adult who has a disability. You can use the pre-paid envelope or fax everything to 1-877-447-2839.
3. It can take up to 45 days for us to work on your application. To find out what’s happening with your application, call 2-1-1.

Important Tips for Filling Out a Paper Application

• Make sure you answer all the questions. If a question does not apply to your family, write “N/A” next to the question.
• Sign your application.
• If you have questions about the items we need you to send us, call us at 2-1-1.