Families with active All Kids, FamilyCare or Moms & Babies cases can add eligible family members onto their case without filing a new application.
If you want to add another family member to your case, fill out a Request for Medical Benefits for Another Family Member HFS 243C form (pdf) and send it to us. Please be sure to include copies of the documents the form tells you to send and your case number. You can find your case number on your All Kids card.
HFS 243C (English) (pdf)
HFS 243CS (Spanish) (pdf)
Send the form to your caseworker at the office that maintains your coverage.
If you have technical problems opening any of these forms, follow these instructions:
Right click the link to the PDF form
Click Save target as... and save the form locally to your Computer
Click the copy of the form that you just saved locally to open with the Adobe Reader
If you don't know the office that maintains your coverage call the All Kids Hotline at 1-866-255-5437 (TTY: 1-877-204-1012).
All Kids Hotline 1-866-ALL-KIDS (1-866-255-5437)