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You can apply even if you or your child already has health coverage, and families with immigrants can apply.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What information is needed to apply?",{"text":68,"@type":64},"Prepare Social Security numbers (or document numbers for eligible immigrants), employer and income information for everyone in the family, current health insurance policy numbers, and information about job-related health insurance available to your family.",{"name":70,"@type":61,"acceptedAnswer":71},"What happens after you submit the application?",{"text":72,"@type":64},"Send the complete signed application to the address on page 62. If you do not have all requested information, you should still sign and submit; follow-up happens within 1–2 weeks with instructions for next steps.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},306303,1791694852,{"code":4,"msg":82,"data":83},"success",[84,89,94,99,104,109,113,118,123],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":86,"show_sort_weight":87,"slug":88},11,"Presentations",90,"presentations",{"id":90,"doc_module":22,"doc_module_name":25,"category_name":91,"show_sort_weight":92,"slug":93},12,"Resumes",80,"resumes",{"id":95,"doc_module":22,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},14,"Invoices",70,"invoices",{"id":100,"doc_module":22,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},15,"Posters",60,"posters",{"id":105,"doc_module":22,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},16,"Social Media",50,"social-media",{"id":110,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":111,"slug":112},17,40,"forms",{"id":114,"doc_module":22,"doc_module_name":25,"category_name":115,"show_sort_weight":116,"slug":117},18,"Letters",30,"letters",{"id":119,"doc_module":22,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},21,"Paper Templates",5,"papers-templates",{"id":124,"doc_module":22,"doc_module_name":25,"category_name":125,"show_sort_weight":4,"slug":126},158,"General","general-158",{"code":4,"msg":82,"data":128},{"doc_id":79,"user_id":129,"nickname":42,"user_avatar":130,"doc_module":22,"category_id":110,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":136,"language":137,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":138,"faqs":139,"seo_title":140,"seo_description":12,"update_tm":141,"read_time":142},13056703019662,"https://ap-avatar.wpscdn.com/avatar/be000253a8e92610077?_k=1778726343310543188","Application for Health Coverage & Help Paying Costs  \nTHINGS TO CONSIDER  \nUse this application to see what coverage you qualify for  \n• Affordable private health insurance plans that offer comprehensive coverage to help you stay well.  \n• A new tax credit that can immediately help pay your premium for health coverage.  \n• Free or low-cost insurance from Medical Assistance.  \nYou may qualify for a free or low-cost program even if you earn as much as $94,000 a year (for a family of 4) .  \nWho can use th is application?  \n• Use this application to apply for anyone in your family.  \n• Apply even if you or your child already has health coverage. You could be eligible for lowercost or free coverage.  \n• If you’re single, you may be able to use a short [form. Visit](form. Visit HealthCare.gov)[ HealthCare.gov](form. Visit HealthCare.gov).  \n• Families that include immigrants can apply. You can apply for your child even if you aren’t eligible for coverage. Applying won’t affect your immigration status or chances of becoming a permanent resident or citizen.  \n• If someone is helping you fill out this application, you may need to complete Attachment C.  \n• Pathways Medical Assistance is a program that provides free or reduced cost Medicaid Coverage to individuals ages 19 to 64, who have household income up to 100% of the Federal  \nPoverty Level (FPL), not otherwise eligible for Medicaid and who meet the eligibility requirements. If you would like to be considered for Pathways, you need to complete this application and Attachment D.  \nApply faster online  \nApply faster online [at](at gateway.ga.gov)[ ](at gateway.ga.gov)[gateway.ga.gov](at gateway.ga.gov).  \nWhat you may need to apply  \n• Social Security Numbers (or document numbers for any eligible immigrants who need insurance)  \n• Employer and income information for everyone in your family (for example, from paystubs, W-2 forms, or wage and tax statements)  \n• Policy numbers for any current health insurance  \n• Information about any job-related health insurance available to your family  \nWhy do we ask for this information?  \nWe ask about income and other information to let you know what coverage you qualify for and if you can get any help paying for it. We’ll keep all the information you provide private and secure, as required by law.  \nWhat happens next?  \nSend your complete, signed application to the address on page 62 .  \nIf you don’t have all the information we ask for, sign and submit your application anyway. We’ll follow-up with you within 1–2 weeks. You’ll get instructions on the next steps to complete your health coverage. If you don’t hear from us, visit [gateway.ga.gov](gateway.ga.gov) or call  \n1-877-423-4746 . Filling out this application doesn’t mean you have to buy health coverage.  \nGet help with this application  \n• Online: [gateway.ga.gov](gateway.ga.gov)  \n• Phone: Call our Help Center at 1-877-423-4746 .  \n• In person: There may be counselors in your area who can help. Visit our website or call 1-877-423-4746 for more information.  \n• En Español: Llame a nuestro centro deayuda gratis al 1-877-423-4746.  \nNEED HELP WITH YOUR APPLICATION? Visit [gateway.ga.gov](gateway.ga.gov) or call us at 1-877-423-4746 . Para obtener una copia de este formulario en Español, llame 1-877-423-4746 . If you need help in a language other than English, call 1-877-423-4746 and tell the customer service representative the language you need. We’ll get  \nyou help at no cost to you. TTY users should call 1-800-255-0135 .  \nSTEP 1 Tell us about yourself.  \n(We need one adult in the family to be the contact person for your application.)  \n1. First name, Middle name, Last name, & Suffix   \n2. Home address (Leave blank if you don’t have one.)   \n3. Apartment or suite number   \n4. City   \n5. State   \n6. ZIP code   \n7. County   \n8. Mailing address (if different from home address)   \n9. Apartment or suite number   \n10. City   \n11. State   \n12. ZIP code  13. County  14. Phone number  15. Other phone","cbCaisMsMjErJot1","https://ap.wps.com/l/cbCaisMsMjErJot1","pdf",345615,69,"English","# THINGS TO CONSIDER\n## Who can use this application?\n## Apply faster online\n## What you may need to apply\n## Why do we ask for this information?\n## What happens next?\n## Get help with this application\n# STEP 1 Tell us about yourself\n# STEP 2 Tell us about your family","[{\"question\":\"Who can use this application?\",\"answer\":\"Use it to apply for anyone in your family. You can apply even if you or your child already has health coverage, and families with immigrants can apply.\"},{\"question\":\"What information is needed to apply?\",\"answer\":\"Prepare Social Security numbers (or document numbers for eligible immigrants), employer and income information for everyone in the family, current health insurance policy numbers, and information about job-related health insurance available to your family.\"},{\"question\":\"What happens after you submit the application?\",\"answer\":\"Send the complete signed application to the address on page 62. If you do not have all requested information, you should still sign and submit; follow-up happens within 1–2 weeks with instructions for next steps.\"}]","Form 94A LP - Application for Health Coverage & Help Paying Costs | PDF",1789835191,24]