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  • Masshealth Notification Of Birth Form (nob-1)

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Commonwealth of Massachusetts EOHHS www.mass.gov/masshealthNOTIFICATION OF BIRTHHospital Name Hospital AddressInstructions: Complete form and print it out Sign form and fax it to 6178878777Contact.

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If you are in a ConnectorCare plan or get a monthly tax credit to lower the cost of your monthly premium, it's especially important to report income changes. If you don't tell us about changes to your income, it could affect your tax refund when you file taxes at the end of the year.

You can also contact the MassHealth Customer Service Center at (866) 682-6745; TDD/TTY: 711. You will need your MassHealth member ID, last name, and date of birth to request your Form 1095-B. We are open Monday through Friday from 8 a.m. to 5 p.m.

This includes postpartum care, abortions and emergency contraceptives, which continue to be legal and accessible in Massachusetts. MassHealth covers a broad range of family planning, reproductive health, and postpartum care services, all with no out-of-pocket costs.

If you get SSP payments only and no other benefits from the Department of Transitional Assistance (DTA), you can request benefit verification from SSP. If you get SSP payments AND other benefits from DTA, you must contact the DTA Assistance Line at (877) 382-2363 for a benefit verification letter.

My Account Page can be accessed at: https://sso.hhs.state.ma.us/vgportal/login. To use My Account Page you must be the head of household (the person who signed the application for benefits) and must be getting benefits yourself.

Acceptable income documents include: Your most recently federal income tax return 1040, 1040A, or 1040EZ. Social Security benefit award letter or annual benefit statement (SSA-1099)

MassHealth Standard Inpatient hospital services. Outpatient services: hospitals, clinics, doctors, dentists, family planning, vision care. Medical services: lab tests, X rays, therapies, pharmacy services, eyeglasses, hearing aids, medical equipment and supplies. Adult day health and adult foster care.

Massachusetts Residency Copy of deed and record of most recent mortgage payment (if mortgage is paid in full, provide a copy of property tax bill from the most recent year) Copy of lease and record of most recent rent payment. Mortgage deed showing primary residence.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232