Apply for Medicaid

You may apply in person, by mail, or online. When we receive your application, the Department of Workforce Services (DWS) will contact you by mail or phone. DWS may need more information to determine if you are eligible for a medical program. DWS will also tell you what proofs you need to provide, like a birth certificate.

How to Apply for Medical Benefits

• Apply Online opens in a new tab
  Note: If you apply online, you do not need to complete a paper application.
• By Mail
  1. Download a Medical Application.
  2. Mail completed application to:
     Department of Workforce Services
     PO Box 143245
     Salt Lake City, UT 84114-3245
• By Fax
  1. Download a Medical Application.
  2. Fax completed application to:
     Department of Workforce Services
     Fax: 801-526-9505
     Toll-free Fax: 1-888-522-9505
• In Person
  1. Download a Medical Application.
  2. You may apply at any Department of Workforce Services (DWS) office. Please click here opens in a new tab and type in your zip code to find an office near you.

For answers to your questions on how to apply, please call the Department of Workforce Services (DWS): Salt Lake County (801) 526-0950 or Toll-free 1-866-435-7414.

Medical Applications

• If you want to apply for medical assistance only, please print out the application below:
  Medical Only Application – English opens in a new tab
  Medical Only Application – Spanish opens in a new tab
• If you want to apply for Nursing Home Medicaid or Long Term Care Medicaid, please print out both the Medical Only Application above and the Long Term Care Addendum below:
  Long Term Care Addendum – English opens in a new tab
  Long Term Care Addendum – Spanish opens in a new tab
• If you want to apply for medical assistance, as well as other programs (Food Stamps, Child Care and/or Financial assistance), please print the application below. If you fill out and turn in this multi-program application, you DO NOT need to fill out a Medical Only Application.
  Multi-Program Application – English opens in a new tab
  Multi-Program Application – Spanish opens in a new tab

If you are not able to print the above applications, you can request to have one mailed to you by calling: Salt Lake County (801) 526-0950 or Toll-free 1-866-435-7414.