How to apply for MassHealth: an 18 step guide

I recently helped a friend of mine enroll in MassHealth, Massaschusett’s very low cost public insurance for the indigent. This friend of mine is incredibly paperwork-averse, so much so that he has never had health insurance, even though he very much qualifies for it and MassHealth is a great deal (free primary care! $1 for generic prescriptions, $3.50 for name brand!) However, I got him to agree to let me apply for him, as I was confident that I have more of an appetite and aptitude for paperwork than he does.

MassHealth, as insurance for low-income Massachusetts residents, really only has two requirements to qualify for it: be low income, and be a Massachusetts resident. And, to be clear, the former is the only requirement you have to prove, as you can simply testify to your residency without providing a rent statement or mortgage. So, in reality, all you really should need to apply to MassHealth is the affidavit form and a paystub.

This, unfortunately, is not the case, as I found out. It is much more complicated than that. Please enjoy my step-by-step enrollment guide.

1. Try to sign up online, be informed that you have to use the one, unified account that applies to all Massachusetts online services. Ask your friend for his login and password to the unified account.

2. Discover that your friend started a health insurance application during the pandemic but never finished it. Because this application was started more than 30 days ago, you can no longer fill out an application online, but instead have to call the phone hotline.

3. The phone hotline is only open 9 am to 5 pm Monday-Friday. Call back later.

4. Call the phone hotline, and get informed that, despite the fact that you have your friend’s social security number, address, birthday, and name, you have to fax a scan of his ID to prove his identity. Do so.

5. After waiting 48 hours, find out that whoever was in charge of processing the fax failed to enter his information correctly from the fax. This means that it’s impossible to continue with the application.

6. Call back repeatedly trying to get in touch with the verification department. Get told by separate representatives that there is no verification department, then that the verification department works for the Massachusetts Health Connector (the insurance marketplace), and, when you call the Health Connector, that the verification department does not take outside calls.

7. Along the way, get disconnected randomly while talking to representatives, so you call back, go through the phone tree and the waiting music, then end up with a new representative who you have to explain the situation to all over again.

8. One representative tells you that this ID verification issue is not a problem, and that she’ll give you a code to apply online. Try to use the code, and then be informed once again that you can’t finish the application online, but you have to call the phone hotline.

9. Give up on trying to figure this out over the phone. Get your friend to come with you to the in-person office.

10. The in-person office is next to the train station. You have to be buzzed in like it’s someone’s apartment. The receptionist doesn’t speak English, but fortunately, one of the workers there does.

11. This worker helps you and your friend fill out your application, including finally properly verifying the ID. Then she tells you, “Ok, we need proof of your income and residency. You can sign this affidavit for your residency, but you need to print out your paystubs.” Ask her if you can use the printer that’s clearly set up for people to use, given that it’s next to a laptop that is open to the public. She says no, citing “confidentiality”.

12. Instead, go to FedEx to print out your friend’s paystubs. At FedEx, the worker is very angry at you for asking him to print these paystubs, and your friend says it reminds him of Dave Chappelle’s Kinko’s sketch.

13. Go back to the office. This time, your new assistant is a woman who tells you that she has a Master’s and a PhD from Georgetown. She informs you that she’s not here to help you fill out your application, but instead to “inform you of your options”.

14. Notice that her desk says “Accenture Public Service”. Ask her if she works for Accenture. She says yes, and informs you that Accenture is the best consulting firm in the world at helping governments. Then she starts to lecture you on how to get tax credits for your private insurance.

15. Tell her that you don’t want private insurance, and that you only want MassHealth. She says she can’t guarantee you that you will get MassHealth. Say that you don’t care, you just need to finish the application now that you have proof of income and residency. She says, “I’m going to give you filling out the application online as your homework for today.”

16. Tell her absolutely not, and that she needs to help you finish the application because it’s been a very long week. She tries to pull up your application but spells your friend’s name wrong repeatedly and tells you that the computer’s not working. You get up and get the woman who helped you before, who then tells this Accenture PhD how to spell a very common American name.

17. The Accenture woman will get very flustered as she works through your application, including failing multiple times at using a scanner to scan your friend’s paystubs and affidavit. At the end, when she finally manages it, she tells you, “In case you need to check on your application, let me write down a phone number you can call.” She gives you the phone number of the MassHealth hotline that you spent 6 or 7 hours on already.

18. Wait 5 business days for the application to process. 

19. If there are no other problems, finally get MassHealth.


You know, I was tempted to just leave this listicle like this, but I just have to say: I’m a college educated guy with a flexible schedule who’s worked my way through a lot of paperwork, including incorporation forms, contracts, taxes, and FDA regulations. This took me 10+ hours, an in-person office visit, a lot of frustration, and a willingness to tell Accenture consultants to shove it.

A single mother with only a high school education working 40 hours a week couldn’t possibly manage to go through the same application process that I did. And that’s unfortunate, because that is exactly the sort of person MassHealth is supposed to help.