If you believe that there is an error in a notice from the Board of Hearings denying eligibility based on trust assets, or if there is no basis for the reason as to why eligibility was denied, use this form to notify the MassHealth Office of the General Counsel. You may use this form if (1) you were denied long-term care benefits based on assets held in a trust; and (2) you believe that the denial notice that you received from the MassHealth Enrollment Center does not comply with two court orders dated June 22, 2018 and October 11, 2018 orders.
This form is NOT for applicants who simply disagree with an eligibility decision. If you disagree with a decision concerning eligibility, you must file an appeal with the Board of Hearings.
To submit your inquiry, you must complete this form.