The Med-QUEST Division accepts applications for medical assistance coverage online, over the phone, or by mail or Fax. Fill out the application as completely as possible. Completed applications ensure more timely determination. If additional information is needed, the Med-QUEST Division will contact you.
- Fillable PDF Application
Fill out the application as completely as possible. Print the completed application and mail, fax or drop off the completed application to the Med-QUEST Division Eligibility Office nearest your home address.
- Telephone, Fax, or Mail