How to Complete and Submit the MassHealth Report a Change Form

If your income, address, household, or other personal details change while you’re on MassHealth, you have 10 days to tell the state using the MassHealth Report a Change form. Members 64 and younger can do this online through the Massachusetts Health Connector portal; members 65 and older use the paper or Adobe-fillable version of the form and submit it online, by mail, or by fax.¹ Missing the deadline can cost you coverage or leave you owing the state money later, so it’s worth doing carefully the first time.

Changes You Have to Report

MassHealth wants to hear about anything that could affect your eligibility or the type of coverage you get. The clock is 10 days from when the change happens.² That includes:

Income changes: a new job, a raise, a job loss, or a shift in self-employment earnings.
A new address, even a move within Massachusetts.
Updated phone number or email.
Household size changes: a new baby, a marriage, a divorce, or a dependent moving out.
A new disability or a change in an existing one.
Gaining or losing other health insurance through an employer, spouse, or any other source.

Report these for every person on your health plan, not just yourself.¹ If you’re not sure whether something counts, call MassHealth Customer Service at (800) 841-2900 and ask. Over-reporting is safer than staying silent.³

Documents to Have Ready

Every change should come with proof. If you send the form alone, MassHealth will mail you a verification request and pause the update until you respond. Gathering the right documents first saves that delay. The Massachusetts Health Connector lists what’s accepted for each category.⁴

Income

For a new job or new pay rate, use pay stubs dated within the past 60 days. A signed earnings statement from your employer on company letterhead works if you don’t have stubs. Your most recent Form 1040 with all attachments, including W-2s, is also accepted.⁴

Self-employed? Submit a 1040-SE with Schedule C, F, or SE, along with any 1099-MISC or 1099-NEC forms. If your tax return no longer reflects what you actually earn, a self-employment ledger or bookkeeping records showing recent profit and loss will stand in.⁴

Address

You need to show you still live in Massachusetts. A current utility bill or work order dated within the past 60 days works, as does a copy of your lease with your most recent rent payment, a mortgage deed, or homeowner’s insurance agreement. School records for a dependent in a public school count too. If you’re experiencing homelessness, a statement from a shelter is accepted.⁴

Household and Identity

When you add someone to your household, include their full legal name, date of birth, Social Security number, and relationship to the head of household. A name change from marriage or divorce needs a copy of the court certificate or updated government-issued ID. For household members who aren’t U.S. citizens, MassHealth may ask for immigration documents such as a Permanent Resident Card, Employment Authorization Card, or I-94.⁴

Write your name and MassHealth member ID on every page you send. Send copies only. Never mail or fax originals.

How to Submit if You’re 64 or Younger

The fastest route is the Massachusetts Health Connector’s online portal. Log in at mahealthconnector.org, open your household information, and update it directly.¹ The system walks you through each field and lets you upload scanned copies of your supporting documents. If you don’t have an account yet, the Mass.gov page for reporting changes links to sign-up instructions for current members through the MA Login system.

You can also skip the portal and submit a paper Report a Change Form by mail or fax using the same process described below.

How to Submit if You’re 65 or Older

Use the MassHealth Report a Change Form. You have two options: fill it out and submit it electronically through the Adobe-based online form linked on the Mass.gov “Report changes to MassHealth” page, or print a copy from the MassHealth Member Forms page on Mass.gov and send it in by mail or fax.¹ To complete the form digitally, you need the free version of Adobe Reader or any version of Adobe Acrobat.

Where to Send It

Mail the completed form and copies of your documents to:

Commonwealth of Massachusetts
Health Insurance Processing Center
PO Box 4405
Taunton, MA 02780¹

Use a mailing method with tracking so you can prove delivery. If you’d rather fax, the MassHealth cover sheet for subsidized applications and eligibility verifications lists the fax number as (857) 323-8300.⁵ Keep the fax confirmation page or your upload receipt. If there’s ever a question about whether you met the 10-day deadline, that’s your evidence.

What Happens Next

MassHealth reviews the report and your documents. If something is missing or unclear, you’ll get a verification request letter in the mail listing exactly what they still need and giving you a deadline to respond. Miss that deadline and your benefits can be denied or reduced.

Once the review is done, MassHealth sends a written notice with the result. It will say whether your coverage continues unchanged, changes to a different type based on your new information, or ends. The notice states the reasons and explains your right to appeal.⁶

If You Disagree With the Decision

You can request a fair hearing through the Office of Medicaid Board of Hearings. Your signed request must reach the Board within 60 calendar days of the date you received the notice. The Board will mail you a hearing notice at least 10 calendar days before the date. You can represent yourself or bring a lawyer, relative, friend, or other spokesperson; local legal aid organizations may be able to represent you for free.⁷

If you can’t make the hearing, call the Board before the date to explain. Not showing up without good cause, or after already rescheduling once, dismisses your appeal. The Board of Hearings can be reached at (617) 847-1200 or toll-free at (800) 655-0338, by fax at (617) 887-8797, or by mail at 100 Hancock Street, 6th Floor, Quincy, MA 02171.⁷

One timing detail matters if MassHealth is about to reduce or end your coverage. The advance notice must arrive at least 10 days before the planned action. If you file your appeal before that effective date, federal Medicaid rules generally require the state to keep your benefits at their current level until the hearing decision comes down.⁶

1
Mass.gov. Report Changes to MassHealth
2
Mass.gov. Frequently Asked Questions for MassHealth Members Younger Than 65
3
Mass.gov. MassHealth
4
Massachusetts Health Connector. Verification Documents
5
Mass.gov. Health Coverage Mail/Fax Cover Sheet
6
eCFR. Fair Hearings for Applicants and Beneficiaries
7
Mass.gov. How to Appeal a MassHealth Decision