You have not provided immigration documentation information. Processing of your Medicaid benefits may be delayed.

Click Continue to move on to the next page of the application or Cancel to return to the Background Information page.

You have not provided immigration documentation information. Processing of your Medicaid benefits may be delayed.

Click Continue to move on to the next page of the application or Cancel to return to the Background Information page.

You have indicated you are in the LEAP program, but that you are also requesting care for this child.

If this is not the child for whom you are requesting care, click Cancel to return to the Background Information Page.

Click Continue to move on to the next page of the application.

You have indicated this person is in the LEAP program, but that you are also requesting care for this child.

If this is not the child for whom you are requesting care, click Cancel to return to the Background Information Page.

Click Continue to move on to the next page of the application.

Since you have indicated that you are applying for Child Care, add the children in need of care to your application.

Click Continue to move on to the next page of the application.

You have not provided current or previous employment, including earned income information. Unearned income can be entered at a later point in the application. If no income information is provided, processing of your Medicaid benefits may be delayed.

Click Continue to move on to the next page of the application or Cancel to return to the Job Information page.

You have not provided any income information at this point in the application. If no income information is provided, processing of your Medicaid benefits may be delayed.

Click Continue to move on to the next page of the application or Cancel to return to the Income Information page.

You have indicated you would like to receive a mailed copy of the Voter Registration and Information Update Form and Voter Registration Notice of Rights and Declination Form. These forms will be mailed to the following address. If this mailing address is incorrect, please navigate to the My Account page to update.

Mailing Address

If you leave this tool, you must answer all questions again. Are you sure you want to leave this page?

If you apply for Child Care, we recommend you also apply for SNAP.

A saved application remains pending for submission. If the application is not submitted within 30 days of creation, it will be deleted.

Click 'Continue' to proceed.

If you apply for cash assistance,
we recommend you also apply for SNAP.