How to Apply to Medicaid

HOW TO APPLY TO MEDICAID

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Should I apply? • Check 1: Check Income Limits • Check 2: Fill out an Online Government Preliminary

Survey •  Information you will need for Survey:

•  Money in cash and bank accounts •  Money from jobs and training •  Government benefits you get now or

have gotten in the past (Medicaid, Social Security, Veteran's benefits)

•  How much you spend on rent, house payments, and utilities

•  How much you spend for adult and child care

•  Your medical facts

What Do I Need to Apply?

ü  Proof of Identity •  Current Driver's License or Department of Public

Safety ID ü  Proof of Citizenship

•  U.S. passport, Certificate of Naturalization, U.S. birth certificate, hospital record of birth, or Medicare card

•  If born in TX: they may be able to look up birth record

ü  Immigration Status •  Resident card (I-551), Arrival/departure form (I-94),

or Papers from U.S. Citizenship and Immigration Services

ü  Legal Representative •  Power of attorney paper, guardianship order, court

order, or similar court documents ü  Social Security, pension, veterans benefits,

Supplemental Security Income (SSI), workers’ compensation, unemployment, or other government benefits

•  Award letter or pay stubs ü  Child support paid

•  Divorce decree, court order, or district clerk record showing how much is paid

ü  Child support received •  District clerk record or letter from the parent who

pays showing how much, how often, and date usually paid; letter must have name , address, phone number, and signature of the parent who pays

ü  Loans, repayments, and gifts (includes someone paying bills for you)

•  Loan agreement or statement from the person giving you money or paying your bills.

•  Must be dated and show that person's name, address, phone number, and signature

ü  Military service •  Current Military ID (Form DD-2), military

orders, or separation papers (Form DD-214)

ü  Veterans benefits, workers' compensation, or unemployment Award letter or pay stubs Proof of income from your job

•  Last 3 pay stubs or paychecks, a statement from your employer, or self-employment record

ü  Bank account •  Most current statement from all account

ü  Medical costs •  Bills or statements from health care

providers from the past 3 months, only if unpaid

•  Dependent care expenses receipts, canceled checks, or signed statement from person you pay; signed statement must show when and how much you pay

Copies of Information Needed to Apply to Medicaid *Need Copies of Both Sides of Documents *Only Need Information Applicable to You

How Do I Apply? • Option 1: Online

•  Step 1: Make an online account: •  Step 2: Follow online tutorial.

How Do I Apply? Option 3: Mail-in Option • Step 1: Print out the form:

•  English: •  Spanish: •  OR: Call toll-free 2-1-1 (or 1-877-541-7905) to get a form mailed to

you. • Step 2: Make copies of Information Needed to Apply to

Medicaid • Step 3: Mail to: HHSC, PO Box 14600, Midland, TX

79711-4600

How Do I Apply? • Option 3: In-Person

•  See if there is an office near you: •  Step 1: Call toll-free 2-1-1 (or 1-877-541-7905) to schedule an

appointment. •  Step 2: Bring copies of information needed to apply to Medicaid.