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Office of Integrated Access and Support

Public Assistance Applications**

Food Supplement Program, TANF, PaS, or MaineCare

     
Application for Food Supplement benefits, TANF, PaS or MaineCare HTML   Adobe PDF*
 
General Application for MaineCare & Food Supplement benefits   Microsoft Word* Adobe PDF*
Documents you might need for General Application interview HTML    
 
MaineCare for Children and Pregnant Women   Microsoft Word* Adobe PDF*
 

Long-term Care

Application for Long-term Care     Adobe PDF*
Documents you might need for Long-Term Care HTML    
 

Private Health Insurance Premium (PHIP) Benefit
Application for PHIP   Microsoft Word* Adobe PDF*
Frequently Asked Questions (FAQ) for PHIP   Microsoft Word* Adobe PDF*
 

Request for Assistance

Request for Assistance Application   Microsoft Word* Adobe PDF*

 

Important Information

**Once you have printed and completed your application for assistance, you can mail the application to any DHHS office. However, if you wish to send the application to the office that services your area, please click on the link "Offices" on the left hand side of the web page. This will provide you with the address of the office nearest you. You may also submit the application in person at any DHHS office.

 

 

**For a free viewer or to request a hard copy