This is a legal form that was released by the Massachusetts Department of Public Health - a government authority operating within Massachusetts. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is ACA-3-0719?
A: ACA-3-0719 is the Massachusetts Application for Health and Dental Coverage and Help Paying Costs.
Q: What is the purpose of ACA-3-0719?
A: The purpose of ACA-3-0719 is to apply for health and dental coverage in Massachusetts and to determine eligibility for help paying costs.
Q: How can I use ACA-3-0719?
A: You can use ACA-3-0719 to apply for health and dental coverage in Massachusetts and to apply for financial assistance to help pay for your coverage.
Q: Do I need to fill out ACA-3-0719?
A: If you want to apply for health and dental coverage in Massachusetts and apply for financial assistance, you need to fill out ACA-3-0719.
Form Details:
Download a printable version of Form ACA-3-0719 by clicking the link below or browse more documents and templates provided by the Massachusetts Department of Public Health.