Title 19 Medicaid Application Form - CT
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.
You can call (860) 593-0404 to schedule a free consultation if you need legal representation.
For additional information, click here.
Edit: Updated with the new version of the W-1F application form (rev. 4/07).
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