Apply for Family and Social Services Administration Medicaid by calling the department offices and requesting the application to be mailed to you. Alternatively, visit the offices to request the form, or visit the FSSA website and print the English or Spanish version of the form.
After getting the application form, fill in all 16 questions. These questions ask about the number of people living in your household, your address and telephone number, and the health plan you desire. The application form also asks whether you live in the state, whether any of the people you listed have a legal guardian and whether any applicants are disabled, blind or pregnant.
Other questions include whether you pay for child care or support a dependent. Provide details about any health insurance coverage you have or whether you lost coverage within the last three months. Also, provide information about the income of everyone in your household and whether the income situation has changed within the last three months. Finally, provide your signature, and declare whether you plan to vote. Ensure all the information you provide is accurate.
After applying for FSSA Medicaid, take the application to your nearest enrollment center or to a local office of the Division of Family Resources in your county.