Application for Health Coverage & Help Paying Costs
Michigan offers several medical assistance programs. Each program covers different groups of people and each program has different eligibility requirements. When you apply for a program, your age, income, financial resources, and other information will be used to determine if you are eligible. You must also meet the financial and non-financial eligibility conditions for that program.
If you're unable to apply online using MI Bridges, you may use the DCH-1426, Application for Health Coverage & Help Paying Costs, the fillable paper application 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. You may also download the printable PDF version of the DCH-1426, Application for Health Coverage & Help Paying Costs.
The MSA-1582, Plan First! Application, and the DCH-0373, Healthy Kids/MIChild application are obsolete and are no longer acceptable assistance applications.