How to Apply for Healthcare
It is important to start your application as soon as possible. This will be the filing date for your benefits. The filing date is the date the agency receives your name, address and signature. Your signature can be collected electronically, by telephone or paper form. You have 30 days to complete the full application.


Call to request a paper application or schedule an
appointment to apply in person at your local agency.
Phone: 1-888-283-0012
To Access a paper application, please visit https://www.dhs.wisconsin.gov/forms/f1/f10101.pdf