You should complete and return the application to the MSP as soon as possible. A delay in applying will delay the date your coverage goes into effect. Please note that if you are enrolled in Medicaid or Medicare Part B, you are not eligible for MSP.
Before you submit your application, make sure that you have provided all the information requested below, if applicable.
- A copy of a letter from your employer or health insurance company stating the amount of your premium and the date your COBRA coverage began.
- A copy of your Mass Health/Commonwealth Care termination letter if you were previously enrolled.
- The four (4) most recent pay stubs for your spouse if you are applying for family coverage. MSP will assign expenses by family size.
- A copy of letter from your Spouse's employer on company letterhead indicating the name of the health insurance plan, Spouse's current premium, the premium to cover the applicant and the date the insurance will be available.
This will help you to avoid delays in processing; however, you should mail your application, even if required documents are not available. The MSP will notify you of your eligibility in writing.
If you have filed your unemployment insurance claim and have not received a Medical Security Program application within two weeks, contact the Medical Security Program at 1-800-908-8801 to have an application mailed to you.