To apply for Medicaid benefits in Alabama, you must fill out the correct form(s) and return them to Medicaid in person, by mail, or online. A list of most frequently used applications and forms is below. If you want to apply for SSI/Medicaid due to disability you may apply at your local Social Security Administration office. If you cannot find the information you need, contact 1-800-362-1504. 

Please note that the Alabama Medicaid Agency does not accept faxed applications.

• Application for help with Medicare premiums- Form 211
  Get more information about these programs
   
• Application for pregnant women, families, and children under 19- Form 291 (English version)- Updated 3/1/09
• Application for pregnant women, families, and children under 19- Form 291 (Spanish version)
• Online Application for pregnant women, families, and children under 19- Form 291
  Get more information about these programs
  Documents you need to apply
   
• Application for the elderly and disabled - Form 204/205 and Application for Medicaid in a hospital, nursing home or ICF/MR - Form 204/205
  Get more information about these programs
   
• Application for birth control and family planning services for women age 19-55 who have no children- Form 357
• Application for birth control and family planning services for women age 19-55 who have children under 19 - Form 291
  Get more information about the Plan First program
  Documents you need to apply
   
• Form to notify Medicaid of an applicant or recipient's situation - Form 234
• Instructions for Form 234
• Form 234 - Blank Form to Fax or Mail
   
• Instructions for Form 234C
• Form to attest to the citizenship or identity of a Medicaid applicant
  Get more information on new Citizenship/Identity Requirements
   
• Form to appoint someone as a Medicaid recipient's representative- Form 202
   
• Form to notify Medicaid of changes to a Medicaid recipient's status (move, income, marital status, etc.) - Form 295 - New- 3/24-09
   
• Instructions for Form 295
   
• Forms for a Medicaid applicant who enters a nursing home and has excess income
   
• Tips for applying for Institutional Medicaid and Home and Community Based Waivers

Applications for temporary Medicaid coverage for hurricane evacuees are no longer being accepted. 

If you want to apply for Social Security disability or SSI (Social Security Income), you will need to contact the Social Security office that serves your area. To find the office that serves your area, click here.
 

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