How to Apply for MassHealth/CommonHealth Your child may be eligible for MassHealth/CommonHealth based on disability not income. Follow these steps below to apply and learn if your child qualifies for coverage: 1. Submit a MassHealth application for Health and Dental Coverage; choose one of the following ways: Apply online, go to: www.MAhealthconnector.org You can create an online account if you do not already have one Print application http://www.mass.gov/eohhs/docs/masshealth/membappforms/aca-3-english.pdf Mail filled-out, signed application to:
Health Insurance Processing Center P.O Box 4405 Taunton, Ma 02780 Fax your filled-out, signed application to: 1-857-323-8300
• Call MassHealth Customer Services Center at 1-800-841-2900 or 1-877-MA ENROLL (877-623-6765).
(TTY: 1-800-497-4648 for people who are deaf, hard of hearing, or speech disabled) •
Visit a MassHealth Enrollment Center (MEC) to apply in person, Monday-Friday 8:45-5:00. 333 Bridge St. Springfield, MA
45-47 Spruce St. Chelsea, MA
367 East St. Tewksbury, MA
21 Spring St., Suite 4 Taunton, MA
2. Complete the MassHealth Child Disability Supplement: http://www.mass.gov/eohhs/docs/masshealth/appforms/mads-child.pdf Mail to: Disability Evaluation Services P.O. Box 2796 Worcester MA 01613-2796 Telephone Number: 1-800-888-3420 3. Complete a MassHealth Medical Records Release Form for all providers who can speak with MassHealth about your child’s disability: http://www.mass.gov/eohhs/docs/masshealth/appforms/mh-mrr.pdf Mail with Child Disability Supplement Disability Evaluation Services P.O. Box 2796 Worcester MA 01613-2796 4. Once your child has been approved for MassHealth (can take up to 90 days), call the Premium Assistance Program, 1-800-862-4840, to check if you are eligible for the Premium Assistance benefit.
The Massachusetts Family to Family Health Information Center is here to help, contact us with questions about: Eligibility and related costs Completing application for coverage and additional paperwork Accessing benefits MA F2F Health Information Center 1-800-331-0688 ext. 301 or
[email protected]