Let’s find out if you’re eligible! You are likely eligible if you have Medicaid.Fill out the form below to see how fast you can get started with pay & benefits. Name * First Name Last Name Phone * (###) ### #### Date of Birth * MM/DD/YY Social Security Number (State verification purposes) * Email Are you the participant? * Yes No Does the participant have Medicaid? (Medicare is NOT enough) * Yes No MercyOne may contact me at this number via calls or texts (including through use of an automatic telephone dialing system and artificial or pre-recorded voicemail) to provide information about or to help me enroll in CDS with MercyOne. Your consent is not required to enroll. Message and data rates may apply. * Yes Thank you!
