How to Apply for MassHealth CommonHealth

MassHealth CommonHealth is a supplemental insurance from MassHealth available to children with qualifying disabilities. CommonHealth will pay for copays and deductibles that are not covered by your private insurance.

The steps to apply for MassHealth CommonHealth are:

1. Submit a Massachusetts Application for Health and Dental Coverage and Help Paying Costs.

Choose one of the following ways to apply:
 ONLINE (MassHealth recommends this way to apply): Visit
www.mahealthconnector.org to complete the application.
 BY MAIL: Download, print, and complete the MassHealth application found here:

Mail to: Health Insurance Processing Center
PO Box 4405
Taunton, MA 02780

 BY FAX: Download, print, and complete the application found here: https://
www.mass.gov/doc/massachusetts-application-for-health-and-dental-coverage-andhelp-paying-costs-0/download. Fax to: (857) 323-8300

 BY PHONE: Call MassHealth Customer Service at (800) 841-2900 or TTY: (800)
497-4648. Hours: Mon-Fri 8 A.M. to 5 P.M.

 IN PERSON: Walk into an enrollment center listed below. Hours: Mon-Fri 8:45 A.M.
to 5 P.M.

Charlestown
529 Main Street
Charlestown, MA 02129

Note: An after-hours drop box is available to submit your application in person.

Chelsea (new location)*
45 Spruce Street
Chelsea, MA 02150

Note: This office has limited parking space.
It is accessible from MBTA bus lines 112 and 114.

Springfield
88 Industry Avenue, Suite D
Springfield, MA 01104

Taunton
21 Spring Street, Suite 4
Taunton, MA 02780

Tewksbury
367 East Street
Tewksbury, MA 01876

Note: An after-hours drop box is available to submit your application in person.

Quincy – MassHealth Central Office
100 Hancock Street, Floor 6
Quincy, MA 02171

Worcester
50 SW Cutoff, Suite 1A
Worcester, MA 01604

2. Submit a MassHealth Child Disability Supplement form.

How do I submit this form?
Download, print, and complete the application found here: https://www.mass.gov/
doc/masshealth-child-disability-supplement-english/download.

Sign the Medical Release forms in the application for each of your child’s providers.

Gather all relevant documents, including recent IEPs, IFCP, and medical testing.

Mail all the above information TOGETHER to: Disability Evaluation Services
PO Box 2796
Worcester, MA 01613-2796

NOTE: It may take up to 90 days for MassHealth to make a disability determination.

FAQs about MassHealth CommonHealth

What is MassHealth CommonHealth?

MassHealth CommonHealth is a program offered
through MassHealth. It is a supplemental insurance policy for children with qualifying disabilities that covers copays, deductibles, and some health services not covered by your private insurance.

Who is eligible for MassHealth CommonHealth?

Children with qualifying disabilities are eligible. Children must also be covered by your family’s private commercial insurance.

How does MassHealth determine if a child has
a qualifying disability?

A qualifying disability is based on a child’s functional status. A qualifying disability is determined by the Child Disability Supplement form, which is submitted as part of the MassHealth CommonHealth application process.

Is family income considered?

No, your family income is not considered for your child’s eligibility. Eligibility is based on the determination of a qualifying disability.

Is MassHealth CommonHealth free?

No, MassHealth CommonHealth is not free care in Massachusetts. When a child is determined eligible for CommonHealth, a premium is calculated based on your family’s income and size.

Which family members do I include in the MassHealth CommonHealth application?

The application requires that you enter information for everyone in your household. You
must do this, even though your child with a disability is the only one eligible for MassHealth CommonHealth.

Can my child see any health care provider with MassHealth CommonHealth?

No, to use MassHealth CommonHealth, your provider must accept both your child’s private insurance and MassHealth CommonHealth.

What is important for me to know when I am applying for MassHealth CommonHealth?

Person #1 in the application should be the adult in the household who is always available to speak with MassHealth. MassHealth will ONLY speak with Person #1 about the child’s information.

For the question that asks if you are you applying for health and dental coverage for this person, only SELECT YES for your child with a disability for which you are applying for MassHealth CommonHealth.

For the question that asks if this person has an injury, illness, or disability that has lasted or is expected to last for at least 12 months, only SELECT YES for your child with a disability for which you are applying for MassHealth CommonHealth.

When asked, make sure to include information about ALL FORMS OF INSURANCE for which your child with a disability is covered. If none of the types of insurance apply, complete the “other coverage” box.

Premium Assistance Program

Does Massachusetts help families with paying for healthcare premiums?

Yes, Premium Assistance is a program in Massachusetts that provides financial assistance to families to pay their premiums. Once you have received MassHealth CommonHealth, call MassHealth Premium Assistance Unit at (800)
862-4840 or TTY: (617) 886-8102 to determine if you are eligible for the benefit.

How can I get additional help applying for MassHealth CommonHealth?

You can make an appointment with an Enrollment Assister at https://my.mahealthconnector.org/enrollment-assisters. You can also call MassHealth Customer Service at (800) 841-2900 or TTY: (800) 497-4648.

Have more questions? Visit us at www.fcsn.org/mfv or call us at (800) 331-0688

Massachusetts Family Voices is a project of Federation for Children with Special Needs.

Funding provided by the U.S. Department of Health & Human Services, Health Resources & Services Administration, Maternal and Child Health Bureau, Division
of Services for Children with Special Health Needs, Grant #H84MC08005 to Massachusetts Family Voices @ the Federation for Children with Special Needs.