Get Ma Ncp-1_dsa

This guide provides clear instructions for completing the MA NCP-1_DSA form online. Designed for custodial parents and legal guardians, it ensures that all necessary information about noncustodial parents is accurately submitted to MassHealth.

Follow the steps to fill out the MA NCP-1_DSA online.

1. Press the ‘Get Form’ button to obtain the MA NCP-1_DSA form and open it in the editing interface.
2. Read the instructions carefully. Gather personal information about the child(ren) and noncustodial parent(s) to ensure smooth completion.
3. In the section for unborn or expected children, indicate if you are currently pregnant and provide any information required if applicable.
4. For each child listed, fill in their first, middle, and last names. If any good cause reasons apply regarding the child’s noncustodial parent, select the appropriate boxes.
5. Complete the noncustodial parent information for each child. Include the first name, middle name, last name, relationship to the child, and other requested details like Social Security number and address.
6. Answer the insurance-related questions to indicate if the noncustodial parent has coverage for the dependents.
7. Ensure that you provide the custodial parent’s signature at the end of the form, certifying that you are the legal guardian and that the information is complete and accurate.
8. After filling out the form, save the changes made. You can choose to download, print, or share the completed document.

Complete your form online today to ensure your child gets the necessary health coverage.