The Medicaid application form, W-1F (rev. 5/04) is now available for download here. I do not recommend anyone complete this application without legal advice. Applying for Medicaid is a detailed investigation into the last five years of financial activity of the applicant and the applicant’s spouse; any errors on your application can cause unnecessary delays when you’re already in a difficult situation.

Edit: Updated with the new version of the W-1F application form (rev. 4/07).

Update: Download is not working, we are working on it.

Related posts:

1. Title 19 Brochure
2. Connecticut Medicaid (Title 19): CSPA
3. Connecticut Medicaid (Title 19): MMNA