Center for Medicaid and CHIP Services: Submit Request

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1. Select a topic

Select a topic

Medicaid Coordination of Benefits

General Information

Submit feedback to our team. Start by selecting a Topic and subtopic on the left.Please do not include personal information in your request.

If submitting a request about an FAQ, please provide the FAQ ID located at the end of the FAQ text (example: "FAQ8152").

If you want to apply for Medicaid or the Children’s Health Insurance Program (CHIP), Please visit www.HealthCare.gov for additional information.

2. Provide contact information

How would you like to be contacted about your request?

New User
Existing User
Remain Anonymous

Login to your account

Username or Email:
Password:	Forgot your username or password?

You can submit a question or feedback without providing any personal information.
Would you like to see responses on an online status screen?

3. Enter your request

Enter details of your request and click Submit Request

Please select a topic/subtopic in step 1.

Request Type (required)
Question
Suggestion
Compliment
Complaint

Your Request

Please do not include any personal information in your message.

Submit a Request