GIC RMT ENROLLMENT FORM (FORM-RMT) - Mass: Fill out & sign online

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Click ‘Get Form’ to open the GIC RMT ENROLLMENT FORM in our editor.
Begin by filling out the 'Insured Information' section. Enter your GIC-ID, name, address, date of birth, and contact information. Ensure all required fields are completed accurately.
Proceed to the 'Retirement Information' section. Indicate whether you will receive a monthly pension from a public retirement system and provide your retirement date.
Select your health plan options under 'MEDICARE PLAN' or 'NON-MEDICARE PLAN' based on your eligibility. Check all applicable boxes for Medicare coverage.
In the 'SPOUSE/DEPENDENT INFORMATION' section, add or drop dependents as necessary. Fill in their last names, dates of birth, and relationships.
Complete the 'FORMER SPOUSE INFORMATION' if applicable, including divorce dates and remarriage status.
Sign and date the authorization section at the end of the form to confirm your selections and understanding of coverage requirements.

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Who is eligible for Mass Rehab Commission?

You are eligible if: you are between the ages of 18 and 59, have a disability that keeps you from doing one or more homemaking tasks. need assistance with in-home tasks to keep you out of the hospital.

Who is eligible for inpatient rehab?

The Massachusetts Rehabilitation Commission (MRC) promotes equality, empowerment and independence of individuals with disabilities. These goals are achieved through enhancing and encouraging personal choice and the right to succeed or fail in the pursuit of independence and employment in the community.

Who is eligible for the Massachusetts rehab commission?

To qualify for care in an inpatient rehabilitation facility, your doctor must state that your medical condition requires the following: Intensive rehabilitation. Continued medical supervision. Coordinated care from your doctors and therapists working together.

Do Massachusetts state employees get health insurance after retirement?

State Retiree GIC benefits include non-Medicare health insurance and/or Medicare health insurance based on eligibility, life insurance, and dental and vision.

What does the Mass Rehab Commission do?

If an individual with a disability (intellectual/developmental, physical, mental health, vision and/or hearing impairment, etc.) wants to find a job, they may be eligible for VR.