State Medicaid Application Forms

Below is a list of State Medicaid Application Forms. This list is for the 50 states within the United States if the information was found available online. This page also provides  a direct link to Online State Medicaid Application Forms state website, and a Printable Medicaid Application forms to be completed by hand or mail to various state offices. Where appropriate please find the contact information for the various State Medicaid Application Offices. We are adding continuously to this list, if your state is not listed please check back or send us an email if you find a broken reference link



Medicaid
Expansion
Apply Online Medicaid
Application
Printable Medicaid ApplicationState Centers for MedicaidContact Number
AlabamaAlabama Online Medicaid
Application
Alabama
Medicaid Application
Alabama Medicaid334-242-5000
AlaskaN/AAlaska Medicaid
Application"
DHSS907-644-6800
ArizonaArizona
Online Medicaid Application
Arizona Medicaid
Application
AHCCCS800-377-3536
ArkansasArkansas
Online Medicaid Application
Arkansas
Medicaid Application
Arkansas Medicaid800-457-4454
CaliforniaCalifornia
Online Medicaid Application
California
Medicaid Application
Medical-HCS 916-445-4171
ColoradoColorado Online ApplicationColorado
Medicaid Application
Colorado
Portal
303-866-3513
ConnecticutConneticut
Online Application
Connecticut
Medicaid Application
Husky Health877-284-8759
DelawareDelaware
Online Medicaid Application
Delaware
Medicaid Application
DMMA302-255-9500
FloridaFlorida
Online Medicaid Application
Florida
Medicaid Application
AHCA(866) 762-2237
GeorgiaGeorgia Online Medicaid
Application
Not
Found Online Visit RSM County Office 
DHS Medicaid888-423-6765
HawaiiHawaii Online Medicaid
Application
Hawaii
Medicaid Application
Hawaii Med-Quest1-877-628-5076
IdahoIdaho Online Medicaid ApplicationIdaho
Medicaid Application
Idaha
Health Welfare
877-456-1233
IllinoisIllinois
Online Medicaid Application
Illinois
Medicaid Application
Ill Dept. Human Services1-800-843-6154
IndianaIndiana Online
Medicaid Application
Indiana Medicaid Application FormIndiana
State Medicaid
800-403-0864
Application
IowaIowa Online Medicaid
Application
Iowa Medicaid ApplicationIowa
Department of Human Services
800-338-8366_ 
KansasKansas Online Medicaid ApplicationKansas
Medicaid Application
KanCare800-817-8617
KentuckyKentucky
Online Medicaid Application
Kentucky Medicaid
Application
Kentucky Medicaid1-800-635-2570
LouisianaLouisiana Online
Medicaid Application
Louisiana
Medicaid Application
Louisiana
Medicaid
1-888-342-6207
MaineMaine Online
Mediciad Application
Maine
Medicaid Application
Maine Care207-287-2409
MarylandMaryland Online Mediciad
Application
Maryland
Medicaid Application
Maryland MedicalVarious 
Massachusetts Massachusetts Online Medicaid
Application
Massachusetts
Medicaid Application
Mass Health617-847-3468
MichiganMichigan Online Medicaid
Application
Michigan
Medicaid Application
MDHC800-292-2550
MinnesotaMinnesota
Online Mediciad Application
Minnesota
Medicaid Application
MinnesotaCareVarious
MississippiMississippi Online Medicaid ApplicationMississippi
Medicaid Application
Mississippi Medicaid1-800-421-2408
MissouriMissouri Online
Medicaid Application
Missouri Medicaid
Application
MO HealthNet573-751-3425
MontanaMontana
Online Medicaid Application
Montana
Medicaid Application Guide
Montana
Medicaid
Various
NebraskaNebraska
Online Medicaid Application
Nebraska Medicaid
Application
Nebraska
Medicaid
(402) 471-3121
NevadaNevada
Online Medicaid Application
Nevada
Medicaid Application
Nevada
Medicaid
(775) 687-1939
New
Hampshire
New
Hampshire Online Medicaid Application
New Hampshire
Medicaid Application
New Hampshire MedicaidVarious
New
Jersey
New Jersey Online
Medicaid Application
New Jersey Medicaid
Application
New Jersey
Medicaid
1-800-356-1561
New
Mexico
New
Mexico Online Medicaid Application
New
Mexico Medicaid Application
New
Mexico Medicaid
1-888-997-2583
New YorkNew York Online Medicaid
Application
New York Medicaid
Application
New York Medicaid877-934-7587
North
Carolina
North Carolina
Online Medicaid Application
North Carolina
Medicaid Application
North Carolina
Medicaid
1-800-662-7030
North
Dakota
North Dakota Online Medicaid
Application
North Dakota Medicaid
Application
North
Dakota Medicaid
(1-877-543-7669
OhioOhio Online Medicaid ApplicationOhio
Medicaid Application 
Ohio Medicaid1-800-324-8680 
OklahomaOklahoma
Online Medicaid Application
Oklahoma
Medicaid Application
OK
Sooner Care
1-800-987-7767
OregonOregon
Online Medicaid Application
Oregon Medicaid
Application
Oregon
Medicaid
503-373-7493
PennsylvaniaPennsylvania
Online Medicaid Application
Pennsylvania
Medicaid Application
Dept
of Public Welfare
1-800-692-7462
Rhode
Island
Rhode Island
Online Medicaid Application
Rhode
Island Medicaid Application
Rhode
Island Medicaid
(401) 462-5300
South
Carolina
South Carolina
Online Medicaid Application
South Carolina Online Medicaid
Application
South
Carolina Medicaid
1-888-549-0820
South
Dakota
South Dakota Online Medicaid
Application
South
Dakota Medicaid Application
South Dakota Medex605-773-3495
TennesseeTennessee Online
Medicaid Application
Tennessee
Medicaid Application
TennCare Medicaid
1-800-462-8261
TexasTexas Online
Medicaid Application
Texas
Medicaid Application
Texas Benefits1-877-787-8999
UtahUtah Online Medicaid ApplicationUtah
Medicaid Application
Utah Medicaid801-538-6155
VermontVermont Online Medicaid ApplicationVermont Medicaid
Application
Greem Mountain
Care
1-800-250-8427
VirginiaVirginia Online Medicaid
Application
Virginia
Medicaid Application
Cover
Virginia
1-800-468-8894
WashingtonWashington
Online Medicaid Application
Washington
Medicaid Application
Washington Social and Health
Service
1-855-923-4633
West
Virginia
West Virginia
Online Medicaid Application
West Virginia
Medicaid Application
West Virginia  Medicaid(800) 642-8589.
WisconsinWisconsin Online Medicaid ApplicationWisconsin Medicaid
Application
Badger Care1-800-362-3002
WyomingWyoming
Online Medicaid Application
Not Found OnlineWyoming  Medicaid1-800-457-3659

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