By filling out a pre-assessment form with questions about your family and income, you can find out if you and your family are elligible for financial assistance for health insurance. The pre-assessment is only 6 questions long and can be taken at the MED-QUEST website here.
There are three different ways to apply for Medicaid.
Online, at the Med-QUEST website here (This is the fastest method).
By calling Med-QUEST Customer service at the toll free number 1-800-316-8005 [Teletype users can call 1-800-603-1201 toll free].
By filling out the fillable PDF application, printing it, and mailing/faxing it to the Med-QUEST Division Eligibility Office closest to you.
You can find a list of Med-QUEST Eligibility Offices here. You can find the instructions for the form here.
If you need assistance applying, Med-QUEST offers customer assistance at the toll free number 1-800-316-8005.
If you have the following conditions, you will need to fill out additional forms:
Applicants who need Long Term Care Services
Include the following forms with your application: DHS 1100, DHS 1100B, DHS 1167, DHS 1169, DHS 1169A, DHS 8003, and DHS 8004
Applicants with disability
Include the following forms with your application: DHS 1100, DHS 1100B, DHS 1127, and DHS 1128
In order to apply, you'll need your:
Legal name
Date of birth
Resident address (If you are homeless, write your general vicinity and zip code)
Mailing address (If you do not have a resident address, write an address where you can receive mail)
Social Security number (If you are applying for assistance for your entire household, you will need the SSNs of each person)
Citizenship and alien status (also for anyone who is applying for assistance)
Tax filing status (Do you intend on filing a tax return? If yes, is it a joint return and how many dependents do you have?)
Pregnancy and expected date of delivery
Income (Including wages, investments, bank accounts, self-employment, etc.)
Any insurance or other coverage
If you choose to apply online, you'll need to create an account first. It will ask you to input your name, email, username, password, and answer three security questions.
You will need to access this account later on should you receive Medicaid, so make sure to write down your information.
To create an account on the Med-QUEST website, click here.