Mass health Application Forms

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Commonly Asked Questions about Mass health Application Forms

Information about citizenship or national status or immigration status. Employer and income information for everyone in your household (for example, from paystubs or wage statements) Information about any job-related or other health insurance that you are currently enrolled in or have access to.
2024 MassHealth Income Standards and Federal Poverty Guidelines Family Size200% Federal Poverty Level300% Federal Poverty Level Monthly Yearly 1 $2,510 $45,180 2 $3,407 $61,320 3 $4,304 $77,4606 more rows
The MassHealth application process often takes a few months from start to finish. For Massachusetts residents who need MassHealth benefits to pay for long-term care, theres no time to waste.
Providers can download a copy of most MassHealth forms or request a supply of forms through the MassHealth website at .mass.gov/masshealth. Or providers can use this request form and fax it to 617-988-8973. Providers can also request forms by e-mailing publications@mahealth.net or by calling 1-800-841-2900.
You may apply for MassHealth at any time during the year. You DO NOT need an open enrollment waiver from OPP to apply for MassHealth.
MassHealth members can have both MassHealth and private health insurance at the same time. If you have both types of insurance, the private health insurance is considered a liable third party or TPL. This means the private health insurance is billed as the primary insurer and MassHealth is the secondary coverage.
MassHealth will give you the most complete coverage that you can get. Your eligibility depends on things like income, citizenship or immigration status, age, and special circumstances. You must be a Massachusetts resident to get any of these services.