Covered Ca Applications - SingleStream - dhcs ca 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the first name, middle name, last name, and suffix of the main contact for this application. Ensure all details are accurate.
3. Fill in the home address, including apartment number, city, state, ZIP code, and county. If there is no home address, check the appropriate box and provide a mailing address.
4. Provide the best phone number to reach you and indicate whether it is a home, cell, or work number. Include an alternative phone number if available.
5. Select your preferred language for communication and how you would like to receive information about this application (phone, mail, or email).
6. Complete Step 2 by providing information about yourself and your family members who will be included in this application. This includes income details and any health insurance currently held.
7. Review all entered information for accuracy before submitting your application. Once completed, send it to Covered California at the provided address.

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