Applications for Public Assistance
Use the links below to apply.
- Complete a paper
Application for Services and send by mail, fax, email, in-person/lobby drop box, direct secure messaging (requires a DSM account), or through a fee agent.
- Contact the Virtual Call Center 800-478-7778 (TDD/Alaska Relay: 7-1-1) and apply for benefits over the phone
- One Fax for All Offices - DPA’s statewide toll-free fax number is 888-269-6520, and Anchorage area residents can dial 907-269-6520.
- See our Contact Us page for more information.
Tips For Faster Service - Send Proof Before We Ask!
Copies of applications are available at local offices, and we can mail one to you if asked.
An electronic application is not available for programs other than MAGI (income-based) Medicaid at this time.
Medicaid Applicants please note:
- Income-based Medicaid applicants are encouraged to apply at www.healthcare.gov. This is the fastest way to see if you’re covered.
- Older age or disability Medicaid applicants should only use the following (paper) application at this time:
(for most assistance programs)
Other Applications
Review or Recertification
- The
Eligibility Review Form (GEN-72) can be used for most programs. The division sends a prefilled review application form with the standard recertification or review notice.
- Please note the reporting requirements for our programs, which can be reported directly to your local office, with a GEN-72 or other form.
Other Forms