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130 CMR: DIVISION OF MEDICAL ASSISTANCE

Trans. by E.L. 252 Rev. 02/13/2026

130 CMR 502.000: HEALTH CARE REFORM: MASSHEALTH: THE ELIGIBILITY PROCESS

502.001: Application for Benefits

(A) Filing an Application. To apply for MassHealth, a person or their authorized representative must file an application online atwww.mahix.org, complete a paper application, complete a telephone application, or apply in person at a MassHealth Enrollment Center (MEC). (1) Date of Application. (a) The date of application for an online, telephone, or in-person application is the date the application is submitted to the MassHealth agency. (b) The date of application for a paper application that is either mailed or faxed is the date the application is received by the MassHealth agency. (2) Online or Telephone Application Requirements. (a) People, or their authorized representative, if applicable, completing an application for MassHealth online at www.mahix.org or by telephone must be identity proofed pursuant to 130 CMR 502.001(A)(3). Eligibility based on an online or telephone application cannot be determined until the identity is proven or a paper application is submitted. (b) If an applicant submits a paper application or applies in person at a MEC, identity proofing is not required. (3) Identity Proofing Process. A person or their authorized representative, if applicable, completing an online or telephone application will be asked a series of questions to prove their identity. (a) If the individual is successfully identity proofed, the application may be submitted and an eligibility determination will be performed. (b) If the individual is not successfully identity proofed, the individual will be asked to provide one or two forms of acceptable documentation proving their identity. (c) When identity proof is received, an individual can submit an application and the eligibility process begins. The MassHealth agency will determine 1. the coverage type providing the most comprehensive medical benefits for which the applicant is eligible and the application is considered submitted on the date of successful identity proofing; and 2. the need to request any corroborative information necessary to determine eligibility, as provided in 130 CMR 502.001(B) through (D). (d) If identity proof is not received, the MassHealth agency is unable to determine eligibility for medical benefits. (e) To prove their identity, a person can submit the acceptable proofs of identity as described in 130 CMR 504.005(A)(1): Acceptable Proof of U.S. Citizenship and Identity or 130 CMR 504.005(A)(3): Acceptable Proof of Identity. (4) Paper Applications or In-person Applications at the MEC Containing Missing or Inconsistent Information. (a) If a paper application is received at a MEC or a MassHealth outreach site and the applicant did not answer all the required questions or if the application is unsigned, the MassHealth agency is unable to determine the applicant’s eligibility for MassHealth. (b) The MassHealth agency requests responses to all the unanswered questions necessary