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State Medicaid Application Forms


Medicaid Application Forms

Below is a list of states within the US with a direct link to Online Medicaid Applications, Printable Medicaid Application forms to be completed by hand or mail to various state offices. There is also 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.



Medicaid
Expansion
Apply Online
Medicaid Application
Printable
Medicaid Application
State Centers
for Medicaid
Contact Number
AlabamaAlabama
Online Medicaid Application
Alabama Medicaid ApplicationAlabama
Medicaid
334-242-5000
AlaskaN/AAlaska Medicaid Application"DHSS907-644-6800
ArizonaArizona Online Medicaid ApplicationArizona Medicaid ApplicationAHCCCS800-377-3536
ArkansasN/AArkansas Medicaid ApplicationArkansas
Medicaid
800-457-4454
CaliforniaCalifornia Online Medicaid ApplicationCalifornia Medicaid ApplicationMedical-HCS 916-445-4171
ColoradoN/AColorado Medicaid ApplicationColorado Portal 303-866-3513 
ConnecticutN/AConnecticut Medicaid ApplicationHusky Health877-284-8759
DelawareDelaware Online Medicaid ApplicationDelaware Medicaid ApplicationDMMA302-255-9500
Florida Florida Medicaid ApplicationAHCA 888-419-3456
GeorgiaN/AGeorgia Medicaid ApplicationDHS Medicaid888-423-6765
Hawaii Hawaii Medicaid ApplicationHawaii QuestVarious
Idaho Idaho Medicaid ApplicationIdaha Health Welfare877-456-1233
IllinoisIllinois Online Medicaid ApplicationIllinois Medicaid ApplicationIll
Dept. Human Services
1-800-843-6154
IndianaIndiana Online Medicaid ApplicationIndiana Medicaid
Application
Family
& Social Services
800-403-0864
IowaIowa Online Medicaid ApplicationIowa
Medicaid Application
Iowa
Medicaid Enterprise
800-338-8366 
Kansas Kansas Medicaid
Application
Kansas Health Wave800-817-8617
Kentucky Kentucky Medicaid ApplicationKentucky
Medicaid
(800) 635-2570
LouisianaLouisiana Online Medicaid ApplicationLouisiana Medicaid ApplicationLouisiana Medicaid1-888-342-6207
Maine Maine Medicaid ApplicationMaine
Care
207-287-2409
Maryland Maryland Medicaid
Application
Maryland Medical(410) 767-5800 
Massachusetts  Massachusetts Medicaid ApplicationMass Health617-847-3468
MichiganMichigan Online Medicaid ApplicationMichigan Medicaid ApplicationMDHC800-292-2550
MinnesotaMinnesota Online Medicaid ApplicationMinnesota Medicaid ApplicationMinnesotaCareVarious
Mississippi Mississippi Medicaid ApplicationMississippi
Medicaid
1-800-421-2408
MissouriMissouri
Online Medicaid Application
Missouri Medicaid ApplicationMO HealthNet573-751-3425
MontanaMontana Online Medicaid ApplicationMontana Medicaid ApplicationMontana MedicaidVarious
NebraskaNebraska Online Medicaid ApplicationNebraska Medicaid ApplicationNebraska Medicaid(402) 471-3121
NevadaNevada Online
Medicaid Application
Nevada Medicaid ApplicationNevada Medicaid(775) 687-1939
New HampshireNew Hampshire Online
Medicaid Application
New Hampshire Medicaid ApplicationNew
Hampshire Medicaid
(603) 271-4344
New JerseyNew Jersey
Online Medicaid Application
New Jersey Medicaid ApplicationNew Jersey Medicaid1-800-356-1561
New MexicoNew Mexico Online Medicaid ApplicationNew Mexico
Medicaid Application
New
Mexico Medicaid
1-888-997-2583
New YorkNew York Online Medicaid ApplicationNew York
Medicaid Application
New
York Medicaid
877-934-7587
North CarolinaNorth Caroline Online Medicaid ApplicationNorth Carolina
Medicaid Application
North
Carolina Medicaid
1-800-662-7030
North DakotaNorth Dakota Online Medicaid ApplicationNorth
Dakota Medicaid Application
North
Dakota Medicaid
(1-877-543-7669
OhioOhio Online Medicaid ApplicationOhio
Medicaid Application 
Ohio
Medicaid
1-800-324-8680 
OklahomaOklahoma
Online Medicaid Application
Oklahoma
Medicaid Application
OK
Sooner Care
1-800-987-7767
OregonOregon
Online Medicaid Application 
Oregon Medicaid ApplicationOregon
Medicaid
800-359-9517 
PennsylvaniaPennsylvania
Online Medicaid Application
Pennsylvania
Medicaid Application
Dept
of Public Welfare
1-800-692-7462
Rhode IslandRhode Island Online Medicaid ApplicationRhode
Island Medicaid Application
Rhode
Island Medicaid
(401) 462-5300
South CarolinaSouth Carolina Online Medicaid ApplicationSouth Carolina
Online Medicaid Application
South Carolina Medicaid1-888-549-0820
South DakotaSouth Dakota Online Medicaid ApplicationSouth Dakota Medicaid ApplicationSouth Dakota
Medex
605-773-3495
TennesseeTennessee Online Medicaid ApplicationTennessee
Medicaid Application
TennCare
Medicaid

1-866-311-4287
TexasTexas Online
Medicaid Application
Texas
Medicaid Application
Texas
Benefits
1-877-787-8999
UtahUtah Online Medicaid
Application
Utah Medicaid ApplicationUtah Medicaid801-538-6155
VermontVermont
Online Medicaid Application
Vermont Medicaid ApplicationGreen
Moutain Care
 1-800-250-8427
VirginiaVirginia Online Medicaid ApplicationVirginia
Medicaid Application
Virginia
Benefits
1-800-468-8894
WashingtonWashington
Online Medicaid Application
Washington
Medicaid Application
Washington
Social and Health Service
1-800-562-3022
West VirginiaWest
Virginia Online Medicaid Application
West Virginia Medicaid ApplicationWest
Virginia  Medicaid
(800) 642-8589.
WisconsinWisconsin Online
Medicaid Application
Wisconsin
Medicaid Application
Wisconsin  Medicaid1-800-362-3002 
WyomingWyoming Online Medicaid
Application
Wyoming
Medicaid Application
Wyoming  Medicaid1-800-457-3659