№ lp_1_2_30042
Official administrative bulletin from a state Medicaid agency describing revisions to a public health coverage application, eligibility scope, procedural changes, and official submission channels for applicants in Massachusetts.
Year: 2025
Date: March 2025
Jurisdiction: Massachusetts
Document type: Administrative bulletin
Issuing authority: Commonwealth of Massachusetts Executive Office of Health and Human Services, Office of Medicaid
Program: MassHealth
Bulletin number: 123
Subject: Updated application for health and dental coverage
Affected form: Application for Health and Dental Coverage and Help Paying Costs (ACA-3)
Applicable populations: Individuals under 65 without long-term-care needs; parents and adult relatives of children under 19
Related form: Application for Health Coverage for Seniors and People Needing Long-Term-Care Services (SACA-2)
Author: Mike Levine, Assistant Secretary for MassHealth
Target audience: Community Health Centers participating in MassHealth
Availability of revised form: March 2025
Source type: Official government bulletin
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.

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