Free or Low-Cost Health Insurance for Families with Children and Pregnant Women
Getting an Application is Easy...
To determine if your children are eligible for Cub-Care or Medicaid, you must submit a written application. At the present time it is not possible to submit an application electronically.
We have several ways for you to obtain an application.
You can look up the DHHS office which serves your geographic area and call them to request an application be sent to you.
You may E-Mail us a request to send you an application.
Or you may open an On-line version of the application, print it off, fill it in completely and sign and return it to your local DHS office. (Be careful to print off and complete both page 1 and 2. We will need each to determine your eligibility.
- Open the Local DHS Office Address & Phone Number listing
- Open On-Line Application* (PDF)
- View On-Line Application Information Help* (PDF)
- E-Mail us your request to have a Cub-Care application mailed to you.