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Get Healthcare Marketplace Printable Application Form

STEP 6 Mail completed application Mail your signed application to Health Insurance Marketplace Dept. Filling out this application doesn t mean you have to buy health coverage. Get help with this Online HealthCare. gov. Phone Call the Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855-889-4325. Depending on your state you may be able to appeal through the Marketplace or you may have to request an appeal with the state Medicaid .

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