If you disagree with a decision made by MassHealth about your coverage, benefits, or eligibility, this interview can help you request a Fair Hearing.

You can use this interview to appeal decisions such as a denial of MassHealth coverage, a determination that you are not eligible, or a reduction or termination of benefits. For example, you may use this form if MassHealth stops covering a medication or service that your provider says you still need.

After you submit your hearing request, the Office of Medicaid, Board of Hearings will review your request and schedule a hearing. At the hearing, you will have the opportunity to explain why you disagree with MassHealth’s decision and provide any supporting information.

Learn how interactive interviews work

More information:

• How to appeal a MassHealth decision

Can I use this tool?

You can use this interview if you want to appeal a decision made by MassHealth.

You may request a hearing if: • You disagree with a decision about your eligibility, benefits, or coverage, or
• MassHealth did not act on your application or request within a reasonable time.

This hearing gives you the opportunity to explain why you think MassHealth’s decision is wrong.

You can file this request for yourself, or you may file on someone else’s behalf if you are authorized to do so (for example, as a legal representative, guardian, or someone with power of attorney).

You must request a hearing within 60 days of receiving a notice of MassHealth’s decision. In some situations, if you did not receive a notice or MassHealth did not act, you may have up to 120 days to request a hearing.

How to select the right court form

Before you start

This interview will guide you through completing a MassHealth Fair Hearing request form.

Before you begin, you should have:

1. Your MassHealth Member ID number (if you or the person you are filing for has one)

2. The notice from MassHealth about the decision you are appealing

3. Any documents that support your appeal (if readily available)

You will have an opportunity to upload documents during this interview. You may also submit documents after you file your hearing request by emailing them to [email protected] before your hearing.

What happens after you finish

After completing this interview, you will get your completed forms ready for filing. This interview may give you more information about what happens next based on your answers. Learn how to file in Massachusetts.

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