You can apply for the Healthy Howard Access Plan by following the steps below:

1. Take the eligibility survey located on our website: www.healthyhowardplan.org/apply. If you appear to be eligible for the Access Plan, you will be given three items:
   • Confirmation code
   • Eligibility Determination Form
   • Required Documents checklist
2. Print out both the Eligibility Determination Form and the Required Documents checklist. Write your confirmation code at the top of your Eligibility Determination Form and complete the form.
3. Look carefully at the Required Documents checklist and decide which documents you will copy and submit along with your Eligibility Determination Form.
4. Mail both the form and copies of your documents to the following address:

Healthy Howard, Inc.
PO Box 1531
Columbia, MD 21044

Applicants who submit a complete packet with the Eligibility Determination Form and all required documents will be contacted within one week to finalize the application process over the phone.