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You must provide the requested information for each child who has a non-custodial parent. To get MassHealth you agree to cooperate with MassHealth and the Child Support Enforcement Division of the Massachusetts Department of Revenue DOR in collecting medical support from non-custodial parents. To do this call DOR at 1-800332-2733 or go to www. mass. gov/dor and click on Child Support. The child s MassHealth benefits will not be affected if you choose to ask for these services or not. If you a ...

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Versions	Form popularity	Fillable & printable
2021	4.9 Satisfied (31 Votes)
2015	4.3 Satisfied (122 Votes)
2013	4 Satisfied (32 Votes)
2013	4.3 Satisfied (132 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is a non custodial parent form Masshealth?

A noncustodial parent is a parent who does not live with their child. This form must be filled out and signed by the custodial parent or legal guardian of any child listed on the application for health care coverage. You must provide the requested information for each child who has a noncustodial parent.

How do I change my last name with Masshealth?

The Details Online + Recommended: The fastest way to update information for your household is through the Massachusetts Health Connector online portal. ... By fax + (857) 323-8300. By mail + Commonwealth of Massachusetts. ... By phone + (800) 841-2900 (TTY: (800) 497-4648)

What documents do I need for Masshealth?

What you need Social Security numbers, if you have them, for every household member who is applying. Federal tax returns, if you file. 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)