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Download an Application

After you have printed the form, fill it out, sign it, attach the necessary documentation (Family Check List) and mail it in. Be sure to fill out the whole form, front and back, and attach the necessary income documentation.

Monthly premiums are based on your household size and monthly income. Most families pay $15 or $20 per family per month. If you need to pay more, we will let you know.

If you send a check or money order for the first month's premium, the check should be made out to: Florida KidCare.

If you have previously applied for Healthy Kids and KidCare please contact our toll-free customer service department at 1-800-821-5437 to reactivate your application. You may not need to submit a new application.

To submit an application you can:

Mail it to:
Healthy Kids and KidCare
Post Office Box 980
Tallahassee, Florida 32302-0980

Fax it to: (866) 867-0054 (TOLL FREE)

Email it to: contactus@healthykids.org

The application form has space for three children. If there are more than three children, attach the information on another sheet of paper.

Family Checklist - What will you need to have handy?

You may complete the My Application Check List to see what forms you need to have handy.