MISSISSIPPI APPLICATION FOR HEALTH BENEFITS (MEDICAID, CHIP, HELP PAYING COSTS FOR HEALTH INSURANCE COVERAGE) This application is used to apply for health coverage for: •

Health First Colorado / Child Health Plan Plus Paper Application 0622Application for Health Insurance & Help Paying Costs See inside Things to Know ...............................

Apply faster online or by phone. Visit dvha.vermont.gov/apply or call Customer Service. One application, five sections Other ways to apply Be sure to have What happens next

Reporting changes If you have already applied for health coverage and simply need to report a change, DO NOT use this application, instead call 1-855-899-9600. Get help with

Application for Apple Health (Medicaid) health care coveragei Application for Health Care Coverage (and to find out if you can get help with costs) Use this application to

NEED HELP WITH YOUR APPLICATION? Visit www.medicaid.la.gov or call us at 1-888-342-6207. If you need help in a language other than English, call 1-888-342-6207 and tell the