MassHealth Checklist

This checklist is intended for use by anyone applying for MassHealth. It includes some of the most common verifications required by MassHealth applicants. This checklist should be used only as a guide, and MassHealth may request additional documentation. Providing these documents to MassHealth can help to decrease application processing time.

IDENTIFICATION AND INSURANCE INFORMATION

  • Copies of both sides of all health insurance cards (including prescription plans, private or retiree insurance, dental, vision)
  • Medicare card or correct Medicare ID
  • Social Security card or correct Social Security ID
  • Proof of citizenship with photo ID
  • Proof of residency status (such as a telephone bill with your address on it)
  • For non-citizens: Copy of legal permanent resident card, work authorization card, I-94 form or visa
  • Copy of most recent Medicare claim and/or most recent health insurance premium bills
  • Proof of disability determination (if applicable)
  • Any recent correspondence/letters regarding health insurance, MassHealth, etc.

INCOME INFORMATION

  • Proof of income (Social Security, SSI, pensions, etc.)
  • Proof of wages or business income
  • Proof of rental income (tax return)
  • Copy of Social Security annual statement of benefits

ASSET INFORMATION

  • Copy of last two months of bank statements (i.e. checking, savings, money market, trust or securities accounts)
  • Copy of life insurance policy (cash value letter)
  • Proof of home ownership (deed or most recent real estate tax bill)
  • Proof of vehicle ownership (vehicle registration)
  • Copy of pre-paid burial plot contract