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Applications to become a MassHealth member

Get the applications you need to become a new MassHealth member, including applications for seniors and long-term-care.

Find out more about applying to MassHealth, the Health Safety Net, or the Children's Medical Security Plan and for seniors or those who need long-term-care. If you need help applying for MassHealth, you can find assistance in your area

If you are already a MassHealth member, or are looking to renew or report changes in your information, you do not need use these applications. 

Table of Contents

Massachusetts Application for Health and Dental Coverage and Help Paying Costs [ACA-3 (07/19)]

Massachusetts Application for Health and Dental Coverage and Help Paying Costs—Additional Persons [ACA-3-AP (07/19)]

Application for Health Coverage for Seniors and People Needing Long-Term-Care Services [SACA-2 (07/19)]

MassHealth Buy-In [MHBI-1 and 2 (03/19)]

Application for Waiver or Reduction of MassHealth Premium – English/Spanish [HW (Rev. 04/18)]

Voter Registration

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