MassHealth: An Overview of the Application Process
On a difficulty scale from “applying for a library card” to “applying for citizenship,” applying for MassHealth falls somewhere in the middle. It’s a straightforward process that requires a dauntingly long application and a bit of a wait. The MassHealth application process often takes a few months from start to finish. For Massachusetts residents who need MassHealth benefits to pay for long-term care, there’s no time to waste. The path to becoming eligible is fraught with perils including the five year look-back period and $2,000 asset limit so advanced planning is best and an experienced guide can mean the difference in getting your application approved.
Step One: Clarify Your Needs
Something that a lot of people find confusing about MassHealth is that there are a few different programs under this general umbrella. Massachusetts residents under 65 who need help paying for medical or dental care can apply for MassHealth benefits using one application, called Massachusetts Application for Health and Dental Coverage and Help Paying Costs. Residents who need this coverage can fill out an online application using Massachusetts Health Connector, apply by phone or submit a completed application by mail, fax or in person at a MassHealth enrollment center.
The application process is a little different for Massachusetts residents who are older than 65 and/or who need long-term-care services. These candidates need to use Application for Health Coverage for Seniors and People Needing Long-Term-Care Services, which is a little more complicated to complete. These applicants may only apply for coverage by completing a physical application and submitting it by mail, fax or in person at an enrollment center.
Step Two: Gather Your Supporting Documents
MassHealth applications ask for a good deal of specific information about things including assets, income and health insurance. It’s a good idea to gather financial statements, health insurance statements, medical bills and recent tax returns before starting the application process. All information must be accurate, so it’s not sufficient to give estimates for things such as bank account balances.
All MassHealth applicants are asked for detailed financial information, but the application’s financial requirements are particularly strict for people who need long-term care. These applicants are required to provide financial statements for the past 60 months (five years) and copies of current health insurance premium bills. You’ll also need policy numbers for any health coverage you have, plus proof of any assets you have and income you receive. All applicants who don’t receive SSI or SSDI benefits must also prove citizenship status and identity. A passport satisfies this requirement.
Step Three: Complete the Application
Applying for MassHealth requires a serious time commitment. The basic application is 18 pages long. Not every section applies to every applicant. A single person can skip several pages entirely.
In addition to the main application, there are four supplemental forms that you may or may not have to complete. Supplement A is for applicants who need long-term care. Supplement B is only for applicants who have American Indian or Alaska Native household members. Supplement C is for applicants who need personal care attendants, and D is for applicants who are eligible for employer-sponsored health coverage.
If you apply with the help of an organization or person, like an attorney, you must also submit a completed Authorized Representative Designation Form.
Step Four: Follow Up if Necessary
After you submit your application, the waiting game begins. A MassHealth caseworker will be assigned to review your application. If the caseworker determines that the application is incomplete, you’ll be notified by phone or in writing and given a deadline by which to submit that missing information. Obviously, responding swiftly is important because any delays in the application process will delay your approval for benefits.
MassHealth will notify you in writing of its decision. An applicant who is denied MassHealth coverage has 30 days to file an appeal.
Starting Your MassHealth Application
Have you started the MassHealth application process, and quickly found yourself confused? You’re in good company. It’s a long and complicated application, and there are plenty of opportunities to make mistakes along the way.
Unless you’re familiar with MassHealth requirements and have plenty of patience, completing the application yourself isn’t ideal. Applicants who need long-term care starting right away, or who have a complicated financial history, should especially consider getting application assistance. Making one mistake during this process can slow down your approval by weeks or even months. And if you’re dealing with failing health or caring for an ailing spouse, taking on the application process alone makes those stressful circumstances worse.
At the Ladimer Law Office, PC, we know MassHealth Applications. We’ve helped countless clients get the coverage they need. We knows the ins and outs of the application process, and how to help you get approved as quickly as possible. Contact us today for answers to your application questions.