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Passwords Should...
  min 8 and 30 max char
  Have at least 1 capital letter
  Have at least 1number
  Be typed correctly twice

Show Passwords


If your child received a notice then select Parent/Guardian
  • Individual
  • Parent/Guardian
  • Provider

Complete the form including the verification fields below

Please enter your NPI to verify your identity

  NPI verified

Please complete the following fields to verify your eligibility

Date of Birth
 Not verified
 Verified

Please complete the following fields to verify your eligibility

Enter the details of one of the children. Multiple invites? Choose one.
Enter child's first name.
 Not verified
 Verified
Enter child's birth date.
Enter child's zip code.

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