Nevada check up application form 2025

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  1. Click ‘Get Form’ to open the Nevada Check Up application in the editor.
  2. Begin by filling out Section 1, which requires information about the head of the household. Include your last name, first name, date of birth, and marital status. Optional fields include Social Security Number and race/ethnicity.
  3. Proceed to Section 2 for details on other adults in the household. Ensure you provide their names, gender, and employment status.
  4. In Section 3, list all children in your home. Complete all required fields including names, dates of birth, and citizenship status. If applicable, indicate if they are pregnant or disabled.
  5. Fill out Sections 4 through 6 regarding child care expenses and employment information. Attach necessary income verification documents as specified.
  6. Complete Section 8 by selecting your preferred health plan from the options provided.
  7. Finally, review all sections for accuracy before signing in Section 11 to affirm that all information is true and complete.

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Simple steps to enroll Use the State of Nevadas pre-screening tool. For Nevada Medicaid, call your local Division of Welfare and Support Services (DWSS) office at. 1-800-992-0900 and choose option 1. For Nevada Check Up, call Nevada Check Up at 1-877-543-7669. Visit your local DWSS office.
Authorized under Title XXI of the Social Security Act, Nevada Check Up (NCU) is the State of Nevadas Childrens Health Insurance Program (CHIP). The Childrens Health Insurance Program was established by Congress to provide access to affordable health insurance for children in working, low-income families.
Maternity care and childbirth are covered by Medicaid and Nevada Check Up. These programs cover pregnant women and their children below certain income levels. You can apply for Medicaid or Nevada Check Up any time during the year.
Nevada Check Up is a program designed for children who do not qualify for Medicaid but whose incomes are at or below 200% of the Federal Poverty Level (FPL). Participants in the Nevada Check Up program are charged a quarterly premium based on income. Nevada Medicaid is often confused with Medicare.
In Nevada, children living in households with an annual income of up to 200% of the federal poverty level may qualify for coverage through Nevada Check Up. This is $50,200 for a family of four.
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Nevada Medicaid and Nevada Check Up cover both inpatient and outpatient hospital care. Before you use hospital services get a referral from your doctor. All medically necessary childhood and adult immunizations are covered. Lab and Radiology services are covered by Nevada Medicaid and Nevada Check Up.

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