Am I Eligible for AFL?

You may be eligible if you are living with and caring for a loved one on Medicaid (Title 19)

Fill out the form to see how fast you can get started:

First name*

Last name*

Phone

Email*

Does the care recipient have Medicaid (Title 19)?*

Yes

No

Do the caregiver and the care recipient live in the same house?*

Yes

No

Are you the spouse of the care recipient? (Spouse caregiver are genrally excluded from being the caregiver)*

Yes

No

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