If you are a Medicare beneficiary, please apply here for assistance with Medicare, Medicare Extra Help, Medicare Premium Help, SNAP applications-food applications or other government benefits programs. Please complete all required fields below.
Regular business hours:
Monday- Friday, 8:30 a.m. - 4:30 p.m.
You can expect a response within 72 hours of receipt of your application.
You may call our Medicare SHIP intake line at 1-866-516-3051 for further help or for clarification. The intake line is available:
Monday - Friday, 9:00 a.m. - 4:00 p.m.
Please scroll down and complete the form below to submit your application.
Completing this application does not guarantee that we can assist you.
