01. Edit your spbp renewal application online
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Spbp renewal application 2026
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- Click ‘Get Form’ to open the spbp renewal application in the editor.
- Begin by entering your full legal name, sex, date of birth, and language preference in Section 1. If you are re-enrolling, include your SPBP identification number.
- In Section 2, provide your principal place of residence. Ensure that the address matches the proof of residency you will submit.
- For Section 3, enter your Social Security Number. If you do not have one, check the appropriate box. Note that re-enrollment does not require a Social Security Card.
- Complete Sections 4 through 12 by providing required information about ethnicity, case manager details, family composition, health insurance coverage, and income verification as outlined in the instructions.
- Review all entered information for accuracy before signing and dating your application in Section 11. If applicable for new enrollment, ensure your prescribing clinician signs Section 12.
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