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
  • Proof of citizenship with photo ID (if not receiving social security)
  • For non-citizens: Copy of legal permanent resident card, work authorization card, I-94 form or visa
  • Most recent health insurance premium bills
  • Proof of disability determination (if applicable)

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 current bank statements (i.e. checking, savings, money market, trust or securities accounts; dated within the last 45 days)
  • 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

Click here for a list of Certified Application Counselors (CAC’s)