Applying Is Easy
You can fill out a CHIP/Children’s Medicaid application using your computer. Click the link below to open an on-screen version of the application. You can fill in the boxes by clicking on each, then typing in your information. Make sure you fill out the entire application. Your information will not be saved electronically unless you save a copy of the file to your computer.
Once you have finished filling out the application:
- print it,
- sign it,
- collect the support documents you need then,
- mail or fax the finished application and support documents.
Fill out an application using your computer/printer
Where to get an application
You can apply for CHIP or Children's Medicaid over the phone, by mail or by fax. You can call us at 1-877-KIDS-NOW (1-877-543-7669) and we'll mail you an application, instructions on how to fill it out and a postage-paid return envelope.
Phone
Call toll-free 1-877-543-7669 (877-KIDS-NOW) Monday through Friday between 8 am and 8 pm Central Time (except federal holidays). People who speak English, Spanish and other languages are available to help. If you have a speech and hearing impairment, please call 1-800-735-2988 (Relay Texas). We can start your application over the phone and send it to you for your signature. All you have to do is sign it and mail it back with copies of your information. It's that easy.
Fax
You can fax your completed and signed application and required information to our toll-free fax number, 1-877-542-5951.
Mail your completed application and copies of required information to:
Texas Health and Human Services Commission
P.O. Box 14200
Midland, TX 79711-9901
Need help?
Call 1-877-KIDS-NOW (1-877-543-7669) for the name and phone number of an organization in your area where you can get free help filling out your application. View a list of these organizations and their phone numbers here.