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DOCUMENTS NEEDED WHEN YOU APPLY FOR HEALTH …

DOCUMENTS NEEDED When You APPLY for HEALTH InsurAnceNYS DOHYou need to provide proof of Identity, Citizenship and/or Immigration Status and Date of 7/1/10, citizen children who provide a social security number are not required to provide identity or citizenship documentation if eligible for Child HEALTH Plus. You can provide ONE of the following DOCUMENTS to prove both Citizenship, Identity and your Date of Birth: l passport book/card OR l Certificate of Naturalization (DHS Forms N-550 or N-570) OR l Certificate of Citizenship (DHS Forms N-560 or N-561) OR l NYS Enhanced Driver s License (EDL).

Workers’ Compensation l Award letter l Check stub Child Support/Alimony l Letter from person providing support l Letter from court l Child support/alimony check stub l Copy of NY Epicard with printout l Copy of child support account information from www.newyorkchildsupport.com l Copy of bank statement showing direct deposit Veterans ...

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UNDOCUMENTED/ILLEGAL ALIENS TREATMENT …

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IMPORTANT INFORMATION REGARDING …

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doa.alaska.gov

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AGE 65 AND OLDER? PACE AND PACENET ELIGIBILITY …

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Medicaid, Alaska, Workers, Compensation, Alaska Medicaid, Workers Compensation, AAM 270. COMPENSATION, Occupational Safety and Health Administration, Employment-at-will, Application for