Who Should Use This Application
Use this application if you are:
- Aged 65 or older and living at home; or
- Any age and need long-term-care services in a medical institution or nursing facility; or
- Eligible under certain programs to get long-term-care services to live at home; or
- A member of a married couple living with your spouse, and
- both you and your spouse are applying for health coverage;
- there are no children under age 19 living with you; and
- one spouse is 65 years of age or older and the other spouse is under 65 years of age.
If this does not describe you, please return to the Apply for Health Coverage page.
If you are disabled and working 40 or more hours a month, or are currently working and have worked at least 240 hours in the last six months, you should complete the Applications for Individuals and Families (ACA-3) , even if you are 65 years old or older.