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MassHealth Member Applications

MassHealth Member Applications

Table of Contents

Massachusetts Application for Health and Dental Coverage and Help Paying Costs [ACA-3 (10/18)]

Massachusetts Application for Health and Dental Coverage and Help Paying Costs—Additional Persons [ACA-3-AP (10/18)]

Application for Health Coverage for Seniors and People Needing Long-Term-Care Services [SACA-2 (10-18)]

MassHealth Buy-In [MHBI-1 (03/18)]

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

Voter Registration

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