Application for Health Coverage & Help Paying Costs
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The DCH-1426, Application for Health Coverage & Help Paying Costs, is the paper application to use to apply for healthcare coverage in Michigan. Health care coverage refers to Medicaid, Healthy Michigan Plan, Children’s Health Insurance Program (CHIP), private health insurance plans that offer comprehensive coverage, and a tax credit that can help pay your premiums for health coverage.
The DHS-1171, Assistance Application no longer contains any information regarding Medicaid and cannot be used to apply for healthcare coverage.
The MSA-1582, Plan First! Application, and the DCH-0373, Healthy Kids/MIChild application are obsolete and are no longer acceptable assistance applications.