Medical Eligibility

Pregnant Women

How do I apply for coverage for pregnant women?

It's easy to apply! You may apply by printing the application below and mailing, faxing, or delivering your application to a Department of Social Services local office. You may also contact your nearest Department of Social Services office or call 1-800-305-3064 to request an application be sent to you.

If you need assistance completing an application contact a Department of Social Services office nearest you or call 1-800-305-3064.

The start date of medical coverage depends on the date the application is received by the Department. An interview is not required to apply for medical assistance, but you may request one.

The start date of medical coverage depends on the date the application is received by the Department of Social Services.  Medical coverage may go back three months prior to the month the application is received in the Department of Social Services if you have unpaid medical bills and you meet eligibility requirements during this time period.  If you are interested in eligibility for the prior three months, include proof of income from month(s) prior to the month the application was submitted to the Department of Social Services.