If you are applying for coverage with the help of an Enrollment Assister, family member, or friend, there is a section of the application that allows you to indicate if someone is helping you. You will need to select “Yes” or “No” before you can continue.
Please note that you are not required to have someone help you in order to apply or receive benefits.
If you are applying with help from another person, when you select “Yes,” you will also need to provide information about that person on that screen. If you are getting help, you will need to provide the required information on the “Who is helping you” screen during the application before you can continue your application.
For some of the types of people that help you, like a Navigator or Certified Application Counselor (CAC), you will also be asked to fill out a form that gives them permission to help you:
| Enrollment Assister Type | Form(s) to Complete |
| Navigator | Navigator Designation Form (NDF) |
| Certified Application Counselor | Certified Application Counselor Designation Form (NDF)and sometimes also a Permission to Share Information (PSI) Form |
| Issuer Enrollment Assister | Issuer Enrollment Assister Designation Form |
When you meet with an Enrollment Assister, they will provide you with the form to complete.
Who can help you?
You can get help from a friend, family member, relative, or other person or organization of your choosing who agrees to help you. Or, you can get help for a certified Enrollment Assister such as a Navigator, Certified Application Counselor, or Issuer Enrollment Assister.
It is up to you to choose someone to help you if you want or need that help. Neither MassHealth nor the Massachusetts Health Connector will choose or assign a person for you.
Certified Enrollment Assisters
Enrollment Assisters are people trained and certified by the Commonwealth of Massachusetts to help residents apply, enroll, and understand their coverage options in Massachusetts. They can help you understand new coverage options available as a result of national health care reform and find the most affordable coverage that meets your needs. The types of Enrollment Assisters in Massachusetts are
- Navigators,
- Certified Application Counselors, and
- Issuer Enrollment Assisters.
Another person that may help you is an Authorized Representative.
Authorized Representatives
If you get help from another type of assister such as a friend, family member, or other trusted person, this person may need to complete an Authorized Representative Designation (ARD) Form (or sufficiently similar document), and mail or fax the form to MassHealth. In addition to providing your authorized representative’s information on the “Who’s helping you?” screen, an Authorized Representative Designation form should be completed for certain situations:
- If because of a mental or physical condition, you cannot designate an authorized representative in writing, a person (not an organization) who is acting responsibly on your behalf can be your authorized representative if that person certifies, by filling out an ARD Form, that you are not able to provide a written designation, and that he or she is acting responsibly on your behalf.
- An authorized representative can also be someone who has been appointed by law to act on your behalf. This person must fill out the ARD Form and either you or this person must submit to us, together with this form, a copy of the applicable legal document stating that this person is lawfully representing you.
- A person appointed by law to act on behalf of the estate of an applicant or member who has died can also serve as an authorized representative by following the instructions in the ARD Form. An authorized representative may be a legal guardian, conservator, holder of power of attorney, or health care proxy, or, if the applicant or member has died, the estate’s administrator or executor. What this person is authorized to do for you or for the applicant or member’s estate will depend on the wording of the legal appointment.You must provide the authorized representative’s date of birth and an e-mail address, if he or she has one, so that we can prove his or her identity and protect your privacy
NOTE: An authorized representative has the authority to act on an applicant’s or member’s behalf in all matters with MassHealth and the Health Connector, and will receive personal information about the applicant or member until we receive a cancellation notice terminating their authority. Their authority will not automatically terminate once we process your application.