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Questions?
You can call 1-800-822-2447 (TTY: 711). We’re here for you Monday through Friday, 8 AM to 5 PM.
Get ready to apply
Get ready to apply
You’ll need about 30 minutes to apply. Before you start, you’ll want to have this info ready:
Employer and income info: household monthly income (employment, Social Security, pension, workers’ compensation, unemployment and child support), pay stubs and W-2 forms
Social Security numbers or document numbers for each household member applying
Date of birth for each household member applying
Immigration info, if it applies (some noncitizens may qualify to enroll, depending on state rules)
Photo ID if you’re applying in person
Policy numbers for any current health insurance
Start here
You can apply:
By mail
By mail: Complete the CHIP application form and send it to the address on the form.
Here’s how you can get it:
Download the application form — English (PDF) | Spanish (PDF)
Request to have a paper application form be sent to you by mail: Email us
Tips for completing your application
- Submit one application form for all children under 19 years of age living in the same household.
- Answer all questions on the form. An incomplete application could delay processing.
- Be sure to add any other info that the application asks you to include. If you complete your application online, you can send the other info by mail to the County Assistance Office in your county.
Choose a health plan
Choose a health plan
As part of your application, you’ll be asked which health plan or managed care organization (MCO) you’d like to choose. You can choose Aetna Better Health Kids as your health plan before submitting your application.
If you don’t choose a health plan then, you’ll still have time to do so. You’ll be sent a form to complete upon approval for CHIP enrollment. After you’ve chosen a health plan, you’ll be able to switch at any time.
What to expect after you enroll
What to expect after you enroll
If you choose Aetna Better Health Kids as your health plan, your coverage will start as soon as the state approves your enrollment. Once you're approved, you’ll get a welcome packet and member ID card in the mail. In the meantime, see what steps you can take when you first become a member.
If you’re under a provider’s care when you join, let us know. We’ll work with you and your provider to make sure you keep getting the care you need.
Not sure if you qualify?
