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Get Ma Saca-2 2018

MAGI rules to determine eligibility. See the Senior Guide for more information. APPLICATION FOR HEALTH COVERAGE FOR SENIORS AND PEOPLE NEEDING LONG-TERM-CARE SERVICES SACA-2 Rev. 06/16 WHAT YOU NEED WHEN YOU APPLY The following MUST be sent with the application when applying for MassHealth the Health Safety Net and the Massachusetts Health Connector SOCIAL SECURITY NUMBER SSN PROOF OF CITIZENSHIP/NATIONAL STATUS You must give us an SSN or proof that one has been applied for for every household member who is applying unless one of the following exceptions applies. Application for Health Coverage for Seniors and People Needing Long-Term-Care Services HOW TO APPLY Please identify which program each household member is applying for on page 1 of the application* You can submit your application in any of the following ways. Mail or fax your filled-out signed application to Hand deliver your filled-out signed application to MassHealth Enrollment Center Central Processing Unit P. O. Box 290794....

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How to fill out the MA SACA-2 online

Filling out the MA SACA-2 online can be a straightforward process if you follow a clear set of instructions. This guide provides a comprehensive overview of each section and field of the form, ensuring you have the necessary information and support to complete the application efficiently.

Follow the steps to successfully complete the form.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Identify the program each household member is applying for on page 1. This could include options like MassHealth or the Health Connector.
  3. Provide your name and address in the designated fields to set up your application correctly.
  4. Fill out information for each household member applying for health coverage, including their Social Security number, date of birth, and relationship to you.
  5. Complete the income and asset sections, ensuring you provide accurate details about current income sources and any assets.
  6. Attach all required supporting documentation, such as proof of identity and income, as specified in the instructions.
  7. Review the completed form for accuracy and completeness, making sure all necessary fields are filled.
  8. Save your changes, and download the filled-out application for your records. You can also print and share the form as needed.

Start completing your MA SACA-2 application online today!

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Applying for MassHealth coverage You can easily apply for MassHealth at www.MAhealthconnector.org.

Eligibility for different types of coverageMassHealth offers different types of coverage based on if you are: A parent living with your children younger than 19 years of age. An adult caretaker relative living with children younger than 19 years of age to whom you are related by blood, adoption, or marriage.

Call MassHealth Customer Services Center at 1-800-841-2900 or 1-877-MA ENROLL (877-623-6765). Visit a MassHealth Enrollment Center (MEC) to apply in person, Monday-Friday 8:45-5:00. 4.

Call MassHealth Customer Services Center at 1-800-841-2900 or 1-877-MA ENROLL (877-623-6765). Visit a MassHealth Enrollment Center (MEC) to apply in person, Monday-Friday 8:45-5:00.

MassHealth is a program run by the Commonwealth of Massachusetts that provides health care benefits for people living in Massachusetts who have medium, low, or no income. ... If you are HIV+ and qualify, we can pay for your health care even if you do not have AIDS or are not disabled.

Submit your MassHealth application online, over the phone by calling 1-800-841-2900, or in person by visiting your local MassHealth Enrollment Center, OR. If you already have CommonHealth as secondary insurance, call 1-800-862-4840, ext. 7 to apply for the MassHealth Premium Assistance program.

Applying for MassHealth coverage You can easily apply for MassHealth at www.MAhealthconnector.org.

MassHealth Limited coverage is available to people 65 and older who meet the income and asset rules for MassHealth Standard or MassHealth Family Assistance, but have an immigration status that keeps them from getting MassHealth Standard or Family Assistance. MassHealth Limited doesn't pay for long-term-care services.

Submit your MassHealth application online, over the phone by calling 1-800-841-2900, or in person by visiting your local MassHealth Enrollment Center, OR. If you already have CommonHealth as secondary insurance, call 1-800-862-4840, ext. 7 to apply for the MassHealth Premium Assistance program.

Social Security numbers, if you have them, for every household member who is applying. Federal tax returns, if you file. Information about citizenship or national status or immigration status. Employer and income information for everyone in your household (for example, from paystubs or wage statements)

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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
Your Privacy Choices
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
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
altaFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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
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