How Do I Apply?

This application is for Healthy Kids Medical Insurance or Medical Coverage for Pregnant Women.

If your child is not currently enrolled in NH Healthy Kids there are four ways to get an application:

1. You can request that an application be mailed to you: Mailed Application
2. You can download and print an application:
   Download English Application
   Baje la Aplicacion en Español
3. You can fill out the application online and print a copy to be signed and mailed to us: Online Application
4. You can get help over the phone by calling our office toll-free at 1-877-464-2447 Monday-Friday 8:00 am – 4:30 pm. We can take your information over the phone and fill in the application for you. Then we will mail the filled in application to you for you to sign and return to us with all of your documents.

If you need help filling out the application, there are many people who can help you. Get more information on our website or by , for questions about applying. (Applications, documents, etc. should not be sent via this email.)

5 Easy Steps to Apply

1. Complete the application, including Yes or No questions.
2. Sign page 6.
3. Review the checklist on page 8 for the documents needed to verify your child’s eligibility. If you are unsure of what documents to send, call us at 1-877-464-2447 and we can help.
4. You must provide a document for proof of citizenship and identity or immigration status. Please review the checklist on page 8 for acceptable documents.
5. Mail the application and documents to:

          NH Healthy Kids

          1 Pillsbury Street, Suite 300
          Concord, NH 03301-3556

After You Apply

Once we receive your application, you will hear from us within 45 days if your application has been approved for a Healthy Kids program or if we need more information before we can process your application. If you have any questions during that time, please call us at 1-877-464-2447 or email  with questions only; please do not email your application or documents.

Already Enrolled?

If your child is currently enrolled in NH Healthy Kids the following application should be used for the yearly renewal of your child's health coverage, Renewal Application. La aplicacion de renovacion tambien se encuentra disponible en Español.