All Washington residents can apply for coverage. Citizenship is not required.
For all individuals or family members you are planning to enroll:
Red fields are required.
Enter Full Legal Name *
Date of Birth (mm/dd/yyyy)*
Use box below to list additional family members
If you want help filling out the application or have any questions, please tell us below.
OR call us toll-free at 1-888-957-5001 during normal business hours.
If nothing appears to happen when you click the
"Apply Now Online!" button, please scroll up and check for
error messages in the form fields.