How to Apply for MassHealth/CommonHealth

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]