How to apply for Medical Coverage

For Families and Children |

Children
Pregnant Women
Families With Children

To request a HealthWave application, call:
1-800-792-4884

FAX Applications to: 800-498-1255

To pick up an application, go to your local SRS office or visit: http://www.srs.ks.gov/Pages/FindSRSLocations.aspx for a list of access sites.

Application Supplements

HealthWave Helpful Hints (English), (Spanish)
HealthWave Verification of Citizenship (EnglishVerification of Citizenship), (SpanishVerification of Citizenship)
HealthWave Brochure (EnglishBrochure), (SpanishBrochure)

To download and print off an application, click here.

For Elderly and Persons With Disabilities |

Elderly
Adults With Disabilities
Children With Disabilities

To request an application, call:
1-888-369-4777

FAX Applications to: 785-296-4813

To pick up an application, go to your local SRS office or visit: http://www.srs.ks.gov/Pages/FindSRSLocations.aspx for a list of access sites.

To download and print off an application, click here.