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Before You Get Started

The Medicaid application is very long, so it is a good idea to gather the information listed below.  You will need to have it ready when you start filling out your application.  You will need to know:

Your legal name;

Your phone number;

Your home address;

Your mailing address;

Your birth date;

Your social security number;

Your citizenship; and

Your ethnicity (optional).

You will need to provide the names of all the people who live in your household.  Include family members who are responsible for each other, such as spouses, those who you give money to or give money to you, children under 19 years old, and the children’s parents.”  

List Everyone Who Lives with You

_____________________________

________________________

Then you will need to provide the following information about each person on your list.

Their legal names;

Their birth dates and ages;

Their relationship to you; and

Their marital status.

What If I’m Not Eligible For Medicaid?

Page 47 of 43

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