In order to complete the application, you will need to know the following information for each household member:
- Name
- Date of Birth
- Address
- Social Security Number
- Immigration information (Ex: foreign passport, I-20, I-94, Visa, Certificate of Naturalization, etc.)
- Gross income information
- Information about any other health insurance available to you (Ex: Employer coverage, student health plan, etc.)
- Email address and password, if applicable (so you can setup an NYSOH login if you don’t already have one)
- NYSOH Username and password if you already have an account
Please call 607.273.8686 if you have questions before the appointment. For directions to our office please look here.