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The form explains eligibility for affordable private plans, a tax credit to help pay premiums, and Medical Assistance options, and notes that immigration status is generally not affected by applying. It lists required information (such as income, Social Security numbers or document numbers, and current insurance details) and outlines what happens next. 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It can be used even if you or your child already has health coverage, and families that include immigrants can apply.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What information is needed to apply?",{"text":114,"@type":110},"You may need Social Security numbers (or document numbers for legal immigrants needing insurance), employer and income information for everyone in your family, policy numbers for current health insurance, and details about job-related health insurance.",{"name":116,"@type":107,"acceptedAnswer":117},"What should I do after completing the form?",{"text":118,"@type":110},"Send your complete, signed application to the address on page 8. 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You could be eligible for lower-cost 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[Apply faster online at](Apply faster online at gateway.ga.gov)[ gateway.ga.gov](Apply faster online at gateway.ga.gov).  \n\n| \u003Cbr>\u003Cbr>\u003Cbr>What you may need to apply\u003Cbr>• Social Security Numbers (or document numbers for any legal immigrants who need insurance)\u003Cbr>• Employer and income information for everyone in your family (for example, |  |  |  |\n| --- | --- | --- | --- |\n| from paystubs, W-2 forms, or wage and tax statements) |  |  |  |\n| \u003Cbr>•• |  |  | Policy numbers for any current health insurance\u003Cbr>Information about any job-related health insurance available to your family |\n| \u003Cbr>| Why do we ask for this\u003Cbr>What happens next? | \u003Cbr>We 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.\u003Cbr>\u003Cbr>Send your complete, signed application to the address on page 8.\u003Cbr>If 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 or call 1-877-423-4746. Filling out this application doesn’t mean you have to buy health coverage. |  |\n| \u003Cbr>| Get help with this application | •• | Online: [gateway.ga.gov](gateway.ga.gov)\u003Cbr>Phone: Call our Help Center at 1-877-423-4746. |\n| In person: here may be counselors in your area who can help. |  |  |  |\n| Visit our website or call 1-877-423-4746 for more information. |  |  |  |\n| • En Español: Llame a nuestro centro de ayuda gratis al 1-877-423-4746. |  |  |  |\n\nT  \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  \n\n| 2. Home address (Leave blank if you don’t have one.) |  |  |  |  | 3. Apartment or suite number |\n| --- | --- | --- | --- | --- | --- |\n| 4. City | 5. State |  | 6. ZIP code | 7. County |  |\n| 8. Mailing address (if different from home address) |  |  |  |  | 9. Apartment or suite number |\n| 10. City | 11. State |  | 12. ZIP code | 13. County |  |\n| 14. Phone number\u003Cbr>( ) – |  | 15. Other phone number\u003Cbr>( ) – |  |  |  |\n\n16. Do you want to get information about this application by email?  Yes  No  \nEmail address:    \n17. What is your preferred spoken or written language (if not English)?  \nSTEP 2  Tell us about your family.  \nWho do you need to include on this application?  \nTell us about all the family members who live with you. If you file taxes, we need to know about everyone on your tax return. (You don’t need to file taxes to ","cbCaigUEnFlvGKFx","https://ap.wps.com/l/cbCaigUEnFlvGKFx","pdf",466998,9,"English","# Things to Do\n## Who can use this application?\n## What you may need to apply\n## Why do we ask for this\n## What happens next?\n## Get help with this application\n# Step 1\n## Tell us about yourself\n# Step 2\n## Tell us about your family","[{\"question\":\"Who can use this Georgia health coverage application?\",\"answer\":\"Use the application to apply for anyone in your family. It can be used even if you or your child already has health coverage, and families that include immigrants can apply.\"},{\"question\":\"What information is needed to apply?\",\"answer\":\"You may need Social Security numbers (or document numbers for legal immigrants needing insurance), employer and income information for everyone in your family, policy numbers for current health insurance, and details about job-related health insurance.\"},{\"question\":\"What should I do after completing the form?\",\"answer\":\"Send your complete, signed application to the address on page 8. If you don’t have all the requested information, sign and submit anyway, then expect follow-up within 1–2 weeks.\"}]","Georgia Application for Health Coverage & Help Paying Costs | PDF",1789835196]