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Get Masshealth Appeal Form

Vice. If you do not understand English or if you are hearing or sight impaired, we will provide an interpreter or assistive device at the hearing at no cost to you. Please tell us what you need in the Other Information section of the form. Your Right to Review Your Case File. You and/or your representative can review your case file before the hearing. If you wish to review your case file, please call the MassHealth Enrollment Center at 1-888-665-9993 (TTY: 1-888-665-9997) or the Connector.

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